Papulosquamous eruptions Flashcards
What is the clinical presentation of plaque psoriasis?
silvery scales and plaques involving the knees, elbows, and scalp; maybe some nail pitting. Generally in extensor surfaces and deep, rich and red in color.
+ Auspitz’s sign (blood pricks)
+ Koebner’s phenomenon (new lesions occuring at sights of trauma)
What can exacerbate psoriasis?
lithium, beta blockers, antimalarials, systemic steroids
What is the treatment for mild to moderate psoriasis?
topical corticosteroids
chronic = anthralin, tazarotene (topical retinoids)
for inverse/facial - tacrolimus
What is the treatment for severe psoriasis?
–mab injections, systemic methotrexate, acitretin, apremilast, special shampoo
How is guttate psoriasis different?
little red papules rash, common in children, and mostly from strep pharyngitis. Diagnosed with throat culture and treated through pharyngitis treatment
What’s a treatment option for almost everything in derm?
sunlight
What is seborrheic dermatitis?
dry, greasy, white-yellow scales with underlying erythema in scalp, face, chest, axilla, gentalia. Could be in flexural skin, maybe in eyelashes. Same thing as cradle cap
What is the most common culprit of fungal infections?
malassezia
How do you treat seborrheic dermatitis?
emollients, topical corticosteroids, topical antifungals, recommend special shampoos
How do you manage severe seborrheic dermatitis?
oral antifungals
What is grover’s disease?
pruritic, papulovesicular eruption on trunk common in white men >40 from a reaction to heat or sweating
What’s treatment for grover’s disease?
topical steroids, retinoids, calciporitol. Persistent disease may require retinoids
What is the clinical presentation of pityriasis rosea?
NON ITCHY eruption with the start being a single red oval plaque “herald patch” followed by more; christmas tree pattern
What should you check for with pityriasis rosea?
ringworm or fungal infection – KOH
How do you manage pityriasis rosea?
You don’t have to do anything!
consider topical steroids, oral antihistamines, if really bad, short course of prednisone
What are the 5 Ps that signify lichen planus?
pruritic, planar, polyangular, purple, papular
What helps differentiate lichen planus?
5Ps, wickham striae (whitish streaks overlying patches), thin nails; in areas of trauma. Can e in genitalia with painful adhesions, or around glans
What is lichen planus associated with?
Hep C infection – test and biopsy
What is the treatment for lichen planus?
topical corticosteroids or calcineurin inhibitors, systemic - hydroxychloroquine, cyclosporine
What’s the clinical presentation of lichen sclerosus et atrophicus?
ivory white atrophic plaque in hourglass shape with scarring – this requires a punch biopsy
What is the treatment for lichen sclerosus et atrophicus?
high potency topical steroids - clobetasol
severe = acitretin
circumcision for males can help
How do drug eruptions present?
extensive rash over trunk and limbs predominately in areas of sun exposure
How to treat drug eruptions?
oral antihistamines, epi if emergency