Papulosquamous diseases Flashcards
What causes tinea corporis (ringworm)
Fungal skin infection caused by dermaphyte pathogens
Spread from people, animals or soil
Tinea corporis presentation
distinct red borders and dry flaky central clearing
patch may grow over time
common in humid climates or humid areas of body
Tinea corporis treatment
Antifungal cream - clotrimazole, ketoconazole, miconazole - BD until clear +48 hrs after
Pityriasis versicolor / tinea versicolor presentation
Superficial fungal infection caused by pityrosporum orbiculare (yeast on skin)
Common in early 20s
Lasts months to years
Copper/brown patches on trunk / neck / arms - resolves and turns into white patches
May itch
Associated with dandruff
PREDIPOSING FACTORS
- hot / humind weather
- high levels of cortisol - cushing’s syndrome, prolonged use of corticosteroids
Pityriasis versicolor / tinea versicolor treatment
Selenium sulfide lotion / shampoo for 15-30 mins for 7-10 days
Topical miconazole for 2 wks
Tinea cruris presentation including RF
Pruritic funal infection of groin - spares genitals
Large scaling
Well dermacated - red , tan or brown plaques
RF
- wearing tight clothing
- travelling to tropical climate
- DM
- obesity
- athletes
- male
Tinea cruris treatment
Topical antifungal - ketaconazole, clotrimazole, miconazole
What is Tinea capitus
Fungal infection of scalp
Tinea capitus presentation
4-14 yrs old
Circumscribed lesion with areas of alopecia
Boggy, erythematous lesions
May have occipital lymphadenopathy
Tinea capitus treatment
Topical
- griseofulvin for 6 - 8 wks in children
- terbinafine 2-4 wks in adults ONLY
Tinea pedis presentation
Athlete’s foot - fungal infection between toes
After walking barefoot in moist areas
Erythematous, scaling lesions
May have itching secondary to bacterial infection
Tinea pedis treatment
Topical antifungals - ketoclonazole, clotrimazole, miconzole BD for 4 wks
What is morbilliform, presentation and treatment
Drug reactions - not allergies
- occurs 7-10 days after starting medication
- maculopapular
- itchy - spares face
Tx - Antihistamines and cooling lotions
Urticarial reaction treatment
Antihistamine, cooling lotion, epinephrine if needed
Psoriasis presentation
Childhood / teenage onset
Famaily history
More common in european descent
sharply marginated erythematous papule with SILVERY WHITE SCALE
scales on sclap, palms, soles, nails, extensors (elbows/knees), lower back, perineum, anterior tibial surface
- doesnt get better with moisturiser
Triggers of psoriasis
Strep infection
Drugs (lithium, antimalarials, beta blockers, NSAIDs)
UV light exposure
Trauma or surgery
Hormonal changes
HIV / AIDs
Smoking
Alcohol
Psychological stress
Complications of psoriasis
Heart failure
Malabsorption
Hypothermia
Dehydration
Mild anaemia
Pregnancy
Psoriasis treatment
Lifestyle - smoking, alcohol, weight loss, stress, anxiety
Emollients
Vitamin D analogues to reduce inflammation - calcipotriol and tacalcitol
High dose steroids straight away and taper (unlike eczema where you start and low and work up)
For scalp psoriasis - emollient (salicylic acid with sulphur)
What are Dermatophyte infections
fungi infection in non viable keratinised skin structures e.g. nails, hair and hair follicles
- usually found in soil
Dx and Tx for dermatophyte infections
KOH microscopy
Tx - antifungals - clotrimazole, micoazole
Lichen planus presentation
FOUR P’S - PRURITIC, PURPLE, POLYGONAL PAPULES
Wrists, ankles, shins, penic, mucous membranes, pubic symphisis
Lichen planus treatment
Topical steroid - strong
UV therapy if steroids not working within 2 wks
Sedating antihistamine - chloramphenamine
Monitor for SCC
