Papulosquamous and Eczematous Dermatoses Flashcards
1
Q
Atopic Dermatitis
A
IgE mediated type I hypersensitivity rxn
- **Filaggrin deficiency**
- TH2 cell involvement : type of T-helper cell
- pruritus
- scaling, non-demarcated, FLEXOR Creases
- tx: topical steroid ointment
- long-term tx: topical calcineurin inhibitors
- phototherapy narrow range UVB
- Dupilumab = inhibits cytokines, $$$ but works very well
2
Q
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/455/q_image_thumb.png?1630870151)
A
Dyshidrotic Eczema
- most common onset is <40 years
- triggers: sweating, emotional stress, warm and humid weather, metals
- ** sudden onset of pruritic clear, tapioca-like tense vesicles on the soles, palms, & fingers (the lateral digits) **
- Diagnosis: clinical
- tx: topical corticosteroid ointments preferred
- will usually resolve spontaneously
- oral corticosteroids for severe cases
3
Q
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/457/q_image_thumb.png?1630870605)
A
Nummular Eczema
- IgE mediated type I hypersensitivity rxn
- Filaggrin gene mutation
- sharply defined coin-shaped lesions
- (especially on the dorsal surfaces of the hands, feet, and extensor surfaces)
- Diagnosis: clinical
- tx: topical corticosteroids
- antihistamines for itching
- topical calcineurin inhibitors
4
Q
Acute Contact Allergic/Irritant Dermatitis
A
Allergic: type IV hypersensitivity rxn; Irritant: non-immunologic rxn
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5
Q
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/460/q_image_thumb.png?1630898927)
A
Seborrheic dermatitis
- caused by increased sebaceous gland activity + hypersensitivity rxn to Malassezia furfur
- greasy appearance of erythematous plaques with fine white scales
- tx: SELENIUM SULFIDE
- sodium sulfacetamide, zinc pyrithione
- ketoconazole shampoo
6
Q
Guttate Psoriasis
A
- small, erythematous “tear-drop” papules with fine scales, discrete lesions and confluent plaques
- often appear after a strep pharyngitis infx
- tx: <3% = topical corticosteroids
- 5-10% = phototherapy + refer to derm
- >10% = phototherapy + consider systemic tx + refer to derm
- methotrexate, retinoids, & biologic
- With Joint involvement: Methotrexate + refer to derm or rheum
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/461/a_image_thumb.png?1630899268)
7
Q
Inverse Psoriasis
A
Lack Scales, most commonly seen in body folds
- tx: <3% = topical corticosteroids
- 5-10% = phototherapy + refer to derm
- >10% = phototherapy + consider systemic tx + refer to derm
- methotrexate, retinoids, & biologic
- With Joint involvement: Methotrexate + refer to derm or rheum
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/462/a_image_thumb.png?1630899301)
8
Q
Plaque Psoriasis
A
keratin hyperplasia due to stratum basale and stratum spinosum proliferation
- TH17-cell activation
- most common on extensor surfaces
- raised, well-demarcated, pink-red plaques or papules with thick silvery scales
- auspitz sign: punctate bleeding with removal of plaque or scale
- **can have joint involvement**
-
tx: <3% = topical corticosteroids
- 5-10% = phototherapy + refer to derm
- >10% = phototherapy + consider systemic tx + refer to derm
- methotrexate, retinoids, & biologic
- With Joint involvement: Methotrexate + refer to derm or rheum
9
Q
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/464/q_image_thumb.png?1630899511)
A
Pityriasis rosea
- associated with viral infections (HHSV 6 or 7)
- usually seen in older children and young adults
- will often start with a herald patch (single, salmon-colored macule) on the trunk followed by a general exanthem 1-2 weeks later
- smaller, very pruritic round or oval salmon-colored papules
- CHRISTMAS TREE PATTERN
- tends to affect trunk and proximal extremities
- tx: self resolving in 6-12 weeks
- for pruritus: antihistamines, topical corticosteroids or oatmeal baths
10
Q
Lichen Planus
A
Associated with Hep C
- purple, pruritic, polygonal pattern that usually affects the volar surfaces of the ankle and wrist
- diagnosis: clinical diagnosis
- tx: topical corticosteroids with occlusive dressing
- rash will usually resolve on its own in 8-12 months
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/469/a_image_thumb.png?1630899744)
11
Q
![](https://s3.amazonaws.com/brainscape-prod/system/cm/369/962/471/q_image_thumb.png?1630899776)
A
Granuloma Annulare
- benign chronic condition
- can be tender, NO SCALING, deep
- center of each ring may be depressed
- erythematous lesions are usually on the dorsal hands, feet, legs or fingers
- tx: corticosteroid
-
topical tacrolimus
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topical tacrolimus