Papulosquamous Disease

Question 1

Is a scale a primary or secondary lesion?

Answer 1

secondary

Question 2

what are possible causes of lichen planus?

Answer 2

• drug reactions
• infection
• emotional stress
• idiopathic

Question 3

what are the 6 P’s to describe lichen planus?

Answer 3

planar
purple
polygonal
pruritic
papules

Question 4

Wickham’s striae is a hallmark of what disease? What is wickham’s striae?

Answer 4

(lichen planus) - delicate white lace-like pattern seen with scales

Question 5

what is the difference btwn acute and chronic forms of lichen planus?

Answer 5

acute- extremely pruritic; occurs rapidly

chronic- higher incidence of oral lesions (may lead to Squamous cell CA)

Question 6

what is koebner’s phenomenon?

Answer 6

lesions develop in a linear pattern in areas of mild trauma

Question 7

describe the nail presentation of lichen planus.

Answer 7

• RIDGING; grooving or splitting
• lysis is common
• pterygium may be seen

Question 8

what type of lichen planus is seen on sun-exposed areas?

Answer 8

actinic lichen planus

*scalp and nails NOT involved usually

Question 9

where does follicular lichen planus most commonly affect?

Answer 9

scalp and legs (not so much the feet)

*may see alopecia

Question 10

a patient presents with pruritic papules on anterior shins and ankles. what derm manifestation do they have?

Answer 10

lichen amyloidosus

Question 11

a 60 y/o woman presents with non-pruritic, round erythematous papules on forearms and ankles. what derm manifesation does she have?

Answer 11

lichen planus erythematous

Question 12

a patient presents with flesh-colored flat-topped papules. nail changes are present. what do they have?

Answer 12

lichen nitidus

Question 13

which derm manifestation occurs because of medications or chemical exposure? the lesions changes color from bright red to rust brown.

Answer 13

lichen dermatitis

Question 14

how do you treat lichen planus?

Answer 14

60-80% is self-limiting disease

• treat symptoms (pruritis)
• sever cases use dapsone or PUVA

Question 15

a solitary round to oval lesion called a herald patch is seen in the trunk and proximal extremity of a patient. patient presents with history of infection, fever/fatigue/sore throat/ lymphadenitis previous. what is the derm manifestation?

Answer 15

pityriasis rosea

Question 16

how do you treat pityriasis rosea?

Answer 16

• self limiting dz

- if symptomatic, treat with topical steroids; antihistamines, or direct sunlight

Question 17

which derm manifestation causes soles and palms to start thickening? initial lesion is a small, smooth, red scaling plaque that slowly enlarges.

Answer 17

pityriasis rubra pilaris

Question 18

how do you treat pityriasis rubra pilaris?

Answer 18

• self limiting dz
• topical emollients
• systemic retinoids

Question 19

which disease causes pinpoint bleeding when the scales are removed? and what is this called?

Answer 19

Auspitz’s sign

*seen in psoriasis

Question 20

a patient presents with red-brown scaly patches on the extensor surface of a joint. removal of the scales causes pinpoint bleeding. what derm manifestation is this?

Answer 20

psoriasis

Question 21

which derm dz affects extensor surfaces primarily? what about flexor surfaces?

Answer 21

extensor- psoriasis

flexor- eczema

Question 22

yellow macules on nails (aka “oil spots”) are characterisitc of what disease?

Answer 22

psoriasis

Question 23

what type of psoriasis is the most stable form?

Answer 23

psoriasis vulgaris

Question 24

what dz is this: well-defined patches with a red base and uniform silvery scaly appearance.

Answer 24

psoriasis vulgaris

Question 25

which type of psoriasis often follows strep throat?

Answer 25

guttate psoriasis

Question 26

which type of psoriasis appears centrally on palms and soles? there is a yellow pustule with an erythematous base.

Answer 26

pustular psoriasis