Papulosquamous Disorders Flashcards
What are papulosquamous disorders?
Conditions with both papules and scales or scaly papules and plaques
What are the characteristics of psoriasis?
Common, chronic and recurrent inflammatory disease of skin
Well circumscribed, erythematous plaques with silver scale
Removal of scale produces small bleeding= Auspitz sign
Increased risk of cardiovascular disease
Associated with HLA-Cw6
What are the targets of treatments for psoriasis?
TNF-Alpha: infliximab, adalimumab(Humira), etanercept (Enbrel)
IL-12, IL-23: ustekinumab (stelara)
IL-17: Ixekizumab,secukinumab
What are the types of psoriasis?
Psoriatic arthritis- pencil in a cup deformities of phalanges
Guttate psoriasis- abrupt onset following strep pharyngitis infection- MC in children
Psoriasis of finger tips- koebner phenomenon
Seborrheic like psoriasis
Inverse psoriasis
Napkin psoriasis
What is the histological feature of psoriasis?
Hyperkeratosis- increased stratum corneum
Parakeratosis- presence of nucleated cells on stratum corneum
Decreased stratum granulosum
Increased stratum spinosum
What are the diseases associated with psoriasis?
Cardiovascular disease Non alcoholic steatohepatitis (NASH) Obesity, hypercholesterolemia Hypertension Inflammatory Bowel Disease
What are the characteristics of Pityriasis Rosea (PR)?
Mild inflammatory exanthem, salmon colored papular and macular lesions often covered with a scale
Hallmark is herald patch= initial lesion, larger than succeeding lesions
Affects trunk and spares sun exposed areas
Christmas tree appearance
Caused by HHV6 and HHV7
What are the characteristics of Pityriasis Rubra Pilaris (PRP)?
Chronic skin disease characterized by small follicular papules, disseminated yellow pink scaling patches and palmoplantar hyperkeratosis
Bimodal incidence: first 5 years of life, 51-55
Classic islands of sparing
What are the characteristics of Lichen Planus?
Pruritic inflammatory diseases
5 P’s : Purple, Polygonal, Planar,Pruritic papules
Affects flexor wrists, face is rarely involved
Hallmark of Wickham striae= net like white lines
Associated with hepatitis C
What are the characteristics of seborrheic dermatitis?
Chronic, superficial inflammatory disease
Yellow greasy appearance, pruritus
Associated with HIV, Parkinson’s and diabetes
Caused by a yeast= Malassezia furfur
What are the characteristics of the secondary syphilis?
Great imitator caused by a spirochete= treponema pallidum
Palms and soles affected
Present with chancre or condylomata acuminatum
Caused temporary, irregular moth eaten alopecia
What are the characteristics of Tinea versicolor?
Caused by Malassezia furfur
Spaghetti and meatballs appearance on KOH prep
Fluorescence of lesions with wood light
What are the characteristics of Tinea corporis?
All superficial dermatophytes involving scalp, face, beard, hand, feet and groin
Caused by Trichophyton rubrum
Classic ring worm pattern
What are the characteristics of Lichen Sclerosis et Atrophicus (LSA)?
Chronic disease of skin and mucosa
Most common in whites
Atrophic lesions, ivory color
Increased risk for genital squamous cell carcinomas
What are the characteristics of Ichtyosis ?
Group of diseases with abnormal differentiation of the epidermis.
Ichthyosis vulgaris= defect in profillagrin synthesis
X-linked Ichthyosis= deficiency of steroid sulfatase
Lamellar ichthyosis= Transglutaminase 1 (TGM 1) deficiency, collodion like covered baby at birth,scales are like armor plate
