Misc. Skin Disorders Flashcards
Lichen Planus Skin Presentation
Flexors: wrists, forearms, ankles, legs
Display Kobner phenomenon
5Ps: Purple, Pruritic, Polygonal, Planar, Papules
Lacy white marks: Wickham’s striae
Lichen Planus Lesions Elsewhere
Scalp: scarring alopecia
Nails: longitudinal ridges
Mouth: lacy white plaques on inner cheeks
Genitals
Lichen Planus Rx
Mild: topical steroids
Severe: systemic steroids
Bullous pemphigoid definition
Autoimmune blistering disease due to auto-antibodies against hemidesmosomes
Bullous pemphigoid presentation
Mainly affects the elderly
Tense bullae on erythemtous base
Can be itchy
Bullous pemphigoid Ix
Biopsy shows linear IgG along the basement membrane and supepidermal bullae
Bullous pemphigoid Rx
Clobetasol (Dermavate)
Pemphigus vulgaris definition
Autoimmune blistering disease due to auto-antibodies againsts desmosomes
May be precipitated by drugs - NSAIDs, ACEi, L-dopa
Pemphigus vulgaris presentation
Younger pts
Large flaccid bullae which ruptures easily
Nikolsky’s sign is positive
Mucosa is often affected
Pemphigus vulgaris Ix
Intraepidermal bullae
Pemphigus vulgaris Rx
Prenisolone, rituximab, IVIg
Acne Vulgaris Pathophysiology
Increased sebum production: androgens and CRH
P. acnes is a skin commensal that flourishes in the anaerobic environment of the blocked follicle
Leads to inflammation
Acne Vulgaris Presentation
Inflammation of pilosebaceus follicles
Comedones (white- or black-heads), papules, pustules, nodules, cysts
Face, neck, upper chest and back
Acne Vulgaris Mx
Pt. education (remember that topical therapy is difficult to apply to the back)
Mild: topical therapy - benzoyl peroxide, erythromycin, clindamycin, tretinoin/isotretinoin
Moderate: topical benzoyl peroxide + oral Abx (doxy or erythro)
Severe: isotretinoin (vit A analogue), may try Dianette in F
Acne rosacea definition
Chronic relapsing remitting disorder affecting the face
