Miscellaneous Skin Disorders, Acne Vulgaris and Acne Rosacea Flashcards
Presentation of lichen planus (8)
5 Ps:
- purple
- planar
- polygonal
- pruritic
- papules
seen on flexors
lacy white marks: Wickham’s striae
display Kobner phenomenon
Other locations affected by lichen planus (4)
scalp: scarring alopecia
nails: longitudinal ridges
mouth: lacy, white plaques on inner cheek
genitals
Rx of lichen planus (2)
mild: topical steroids
severe: systemic steroids
Pathology of bullous pemphigoid
Abs against hemidesmosome>blistering
Presentation of bullous pemphigoid (3)
mainly in elderly
tense bullae on erythematous base
can be itchy
Ix for bullous pemphigoid (2)
biopsy shows linear IgG along BM and subepidermal bullae
Rx of bullous pemphigoid
clobetasol (dermavate)
pathology of pemphigus vulgaris (2)
Abs against desmosomes> blistering
can be triggered by:
- NSAIDs
- ACE-i
- L-dopa
Presentation of pemphigus vulgaris (4)
younger patients
large flaccid bullae which rupture easily
Nikolsky’s sign +ve: shearing force dislodges epidermis
mucosa often affected
Ix for pemphigus vulgaris
subepidermal bullae
Rx of pemphigus vulgaris
Prednisolone
rituximab
IVIg
Pathology of acne vulgaris (2)
increased sebum production
P. acnes is a skin commencal which flourishes in anaerobic environment of hair follice>inflammation
Presentation of acne vulgaris (3)
inflammation of pilosebaceous follicles
comedones (white or black), papules, pustules, nodules, cysts
affects face, neck, upper chest and back
Mx of acne vulgaris (3)
mild-topical therapy:
- benzoyl peroxide
- erythromycin/clindamycin
- tretinoin/isotretinoin
moderate:
-topical benzoyl peroxide+oral Abx(doxycycline/erythromycin)
severe:
- isotretinoin:SEs-teratogenic, depression, hepatitis, hyperlipidaemia, dry skin, myalgia. Monitor lipids, LFTs, FBC.
- in women can try cyproterone acetate (Dianette)
Presentation of acne rosacea (3)
chronic flushing triggered by alcohol/spicy food
fixed erythema: chin, nose, cheeks, forehead
telangiectasia, papules and pustules (no comedones)
