MSCT Week 5: Papulosquamous Skin Eruptions Flashcards

1
Q

Papulo means in papulosquamous eruptions

A

Plaque - raised skin lesion with epidermal component

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2
Q

Squamous in papulosquamous means

A

scale or excess shedding of keratinocytes

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3
Q

Pathology?

A
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4
Q

Pathology?

A
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5
Q

Hyperkeratosis is?

A

Thickened Stratum Corneum

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6
Q

Parakeratosis is?

A

Presence of keratinocytic nuclei in the stratum corneum

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7
Q

Acanthosis is?

A

Thickened spinous layer also known as epidermal hyperplasia

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8
Q

Acanthosis AKA?

A

Epidermal Hyperplasia

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9
Q

Pathology?

A
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10
Q

Descriptions

A
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11
Q

Pathology?

A
  • Acanthosis
  • Hyperkeratosis
  • Parakeratosis
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12
Q

Pathology?

A

Acanthosis

Hyperkeratosis

cant see Parakeratosis

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13
Q

Pathology?

A
  • Hyperkeratosis
  • Parakeratosis
  • Neutrophils in the stratum corneum
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14
Q

Pathology?

A

Hyperkeratosis

Parakeratosis

acanthosis might be hard to see from this magnification

neutrophils in the stratum corneum

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15
Q

What is Psoriasis?

A

A chronic, inflammatory skin condition

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16
Q

Psoriasis prevalence?

A
  • 2% of the US population
  • can be seen at any age, peaks in diagnosis in early 20s and middle age
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17
Q

Psoriasis Risk Factors

A

Strong genetic component (1/3 have affected 1st degree family)

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18
Q

Psoriasis Characteristics

2 listed

A
  • Waxes & Wanes but has a chronic tendency
  • May or may not be itchy
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19
Q

Psoriasis Characteristics Overview

A
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20
Q

Psoriasis Age of Onset

A

can be seen at any age, peaks in diagnosis in early 20s and middle age

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21
Q

Psoriasis Morphologies

8 listed

A

Plaque

Guttate

Inverse/Flexural

Generalized/Erythrodermic

Pustular

Acral/Palmoplantar

Auspitz Sign = pinpoint bleeding in dermis when scale removed

Clinical pearl: Nail Pitting

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22
Q

Guttate Psoriasis

A

Having drops or droplike markings

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23
Q

Inverse/Flexural Psoriasis appears where on the body?

A

in the skin folds like arm pits

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24
Q

Psoriasis type?

A

Plaque

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25
Q

Psoriasis type?

A

Inverse/Flexural

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26
Q

Psoriasis type?

A

Generalized/Erythrodermic

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27
Q

Psoriasis type?

A

Guttate

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28
Q

Psoriasis type?

A

Pustular

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29
Q

Psoriasis type?

A

Acral/Palmoplantar

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30
Q

Common locations of psoriasis

A
31
Q
A
32
Q

Identify

A
33
Q

Identify

A
34
Q

Topical Treatments for Psoriasis

5 listed

A
35
Q

Corticosteroids for types of Psoriasis

A

All types

36
Q

Calcipotriene (Vitamin D Derivative) for types of Psoriasis

A
  • In combination or rotation w/ topical steroids
  • facial or genital
37
Q

Retinoids for types of Psoriasis

A

Thicker plaques, in combination w/ topical steroid

38
Q

Coal Tar for types of Psoriasis

A

Plaque Psoriasis

39
Q

Calcineurin Inhibitors for types of Psoriasis

A

Off-label for facial or flexural/genital

40
Q

Corticosteroids Side Effects

A

Skin Atrophy

Striae

Hypertrichosis

if used inappropriately (systemic absorption)

41
Q

Calcipotriene Side Effects

A
  • Skin irritation
  • Mild photosensitivity
42
Q

Coal Tar Side Effects

A

Skin irritation

Odor

Staining of clothing

43
Q

Calcineurin Inhibitors Side Effects

A

Skin irritation

44
Q

Systemic Treatments for Psoriasis

A
45
Q

Systemic Treatments for Psoriasis When should they be considered?

A

in widespread/debilitating disease

46
Q

Systemic Treatments for Psoriasis and corticosteroids

A

Do not give systemic corticosteroids as this may severely flare disease on rebound after discontinuing

47
Q

Psoriasis Histological characteristics

A

Acanthosois

hyperkeratosis

hyper-proliferative disease (14 days to rise from basal to corneum instead of 28 days)

48
Q

Striae are?

A

Stretch marks

49
Q

Psoriasis has been recently shown to have an increased risk or association with?

A
  • Cardiovascular Disease
  • Obesity
50
Q

Atopic Dermatitis is associated with?

A

Asthma

51
Q

Asthma is associated with this skin condition?

A

Atopic Dermatitis (Eczema)

52
Q

Psoriatic Arthritis and other comorbidities

A
53
Q

Psoriasis is a __________ disease with __________ inflammation

A

systemic disease with systemic inflammation

54
Q

Pathology?

A

Atopic Dermatitis

  • Spongiosis (desmosomal attachments visible between keratinocytes)
  • eosinophils in the bottom left
  • langerhans cells
55
Q

Atopic Dermatitis AKA

A

Eczema

56
Q

Atopic Dermatitis is usually diagnosed when?

A

In infancy or early childhood

57
Q

Atopic Dermatitis Characteristics

A
  • Almost always itchy (pruritus)
  • up to 25% of the pediatric population but can persist into adulthood
  • waxes & Wanes but a chronic condition
58
Q

Atopic Dermatitis is most commonly found where on the body?

A
59
Q

Identify

A
60
Q

Histology for Atopic Dermatitis

A
61
Q

Pathology?

A
  • Atopic Dermatitis
  • spongiosis
62
Q

What Percentage of children with atopic dermatitis will have or develop another atopic condition?

A

50-80%

63
Q

Pillars of treatment: Atopic Dermatitis

4 listed

A
  • issue with skin barrier so prevent infection or treat with antibiotics, irritants or allergens Topical antibiotics
  • addressing the itch-rash cycle (oral antihistamines)
  • Anti-inflammation (topical cortical steroids (rarely systemics)
64
Q

Question 1

A

Allergic Contact Dermatitis

65
Q

Contact Dermatitis is caused by?

A

Inflammatory Rxns caused by an externally applied substance

  • either allergic or irritant
66
Q

Allergic Contact Dermatitis description

A

Contact w/ particular substance causes DELAYED hypersensitivity Reaction

Previous exposure/sensitization required

67
Q

Irritant Contact Dermatitis Description

A
  • Contact with an irritating or toxic substance causes rxn (in most people who come in contact w/ it depends on the frequency
  • No previous exposure required
  • Ex. Harsh soap/detergent, alcohol gel, etc
68
Q

Allergic Contact Dermatitis (ACD) clinical description

A
69
Q

Question 2

A

reddish polygonal pruritic bumps on the wrist

70
Q

Identify

A
71
Q

Pathology

A
  • hypergranulosis
  • band of lymphocytes at the dermal-epidermal junction (lykinoid infiltrate)
  • sawtooth of Rete Ridges
  • Lichen Planus
72
Q

Virus shown to be associated with Lichen Planus?

A

Hepatitis C Virus

73
Q

Clinical pearl of Psoriasis

A

Nail Pitting

&

Auspitz sign