Papulosquamous Diseases -Pham

Question 1

What are the treatments for psoriasis?

Answer 1

• Corticosteroid scalp solutions bid PRN
• Dovonex cream or ointment (vitamin D analog)
• Topical corticosteroid cream
• phototherapy (narrowband UVB)

Question 2

What should you avoid giving to patients with psoriasis? Why?

Answer 2

-avoid intramuscular or oral steroids because the pts can get rebound pustular psoriasis (fever for several days and sterile pustules all over)

Question 3

What is Guttate Psoriasis? What is the most common cause of this?

Answer 3

• Eruption of small, scaly papules over the trunk and proximal extremities.
• most commonly caused by Streptococcal throat infection

Question 4

What is a Herald patch? What is this associated with? What is the cause of this?

Answer 4

• a herald patch is a 2-4 cm oval patch that is the first lesion seen in Pityriasis Rosea
• it is later followed by a “christmas tree” pattern rash
• Caused by HHV 6 and HHV 7

Question 5

What is the treatment for Pityriasis Rosea?

Answer 5

• Antihistamines
• Acyclovir
• Valtrex
• Corticosteroid cream
• Phototherapy

Question 6

What is Seborrheic Dermatitis? What is the treatment?

Answer 6

• caused by Malassezia fur fur yeast
• scaly patches and plaques on face and scalp most common

Tx:

• Nizoral 2% shampoo 2x/week
• corticosteroid scalp solution or foam bid PRN
• Mild Topical corticosteroids and Nizoral cream for face/ears

Question 7

What is Lichen Planus? What is it due to? What does it look like?

Answer 7

• Inflammatory disorder
• Caused by activated CD8+ T cells release cytokines and chemokines
• 5Ps: Pruritic, Purple, Planar, Polyangular Papules
• Wickham’s striae: Whitish reticulated networks over the surface of lesions (can put mineral oil on the lesion to see it better

Question 8

What is a common cause of Lichen Planus? What is the treatment?

Answer 8

• Hepatitis C

- tx: potent corticosteroid creams and a Class 1 Scalp solution bid PRN