Papulosquamous eruptions

Question 1

What is the clinical presentation of plaque psoriasis?

Answer 1

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)

Question 2

What can exacerbate psoriasis?

Answer 2

lithium, beta blockers, antimalarials, systemic steroids

Question 3

What is the treatment for mild to moderate psoriasis?

Answer 3

topical corticosteroids
chronic = anthralin, tazarotene (topical retinoids)
for inverse/facial - tacrolimus

Question 4

What is the treatment for severe psoriasis?

Answer 4

–mab injections, systemic methotrexate, acitretin, apremilast, special shampoo

Question 5

How is guttate psoriasis different?

Answer 5

little red papules rash, common in children, and mostly from strep pharyngitis. Diagnosed with throat culture and treated through pharyngitis treatment

Question 6

What’s a treatment option for almost everything in derm?

Answer 6

sunlight

Question 7

What is seborrheic dermatitis?

Answer 7

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

Question 8

What is the most common culprit of fungal infections?

Answer 8

malassezia

Question 9

How do you treat seborrheic dermatitis?

Answer 9

emollients, topical corticosteroids, topical antifungals, recommend special shampoos

Question 10

How do you manage severe seborrheic dermatitis?

Answer 10

oral antifungals

Question 11

What is grover’s disease?

Answer 11

pruritic, papulovesicular eruption on trunk common in white men >40 from a reaction to heat or sweating

Question 12

What’s treatment for grover’s disease?

Answer 12

topical steroids, retinoids, calciporitol. Persistent disease may require retinoids

Question 13

What is the clinical presentation of pityriasis rosea?

Answer 13

NON ITCHY eruption with the start being a single red oval plaque “herald patch” followed by more; christmas tree pattern

Question 14

What should you check for with pityriasis rosea?

Answer 14

ringworm or fungal infection – KOH

Question 15

How do you manage pityriasis rosea?

Answer 15

You don’t have to do anything!
consider topical steroids, oral antihistamines, if really bad, short course of prednisone

Question 16

What are the 5 Ps that signify lichen planus?

Answer 16

pruritic, planar, polyangular, purple, papular

Question 17

What helps differentiate lichen planus?

Answer 17

5Ps, wickham striae (whitish streaks overlying patches), thin nails; in areas of trauma. Can e in genitalia with painful adhesions, or around glans

Question 18

What is lichen planus associated with?

Answer 18

Hep C infection – test and biopsy

Question 19

What is the treatment for lichen planus?

Answer 19

topical corticosteroids or calcineurin inhibitors, systemic - hydroxychloroquine, cyclosporine

Question 20

What’s the clinical presentation of lichen sclerosus et atrophicus?

Answer 20

ivory white atrophic plaque in hourglass shape with scarring – this requires a punch biopsy

Question 21

What is the treatment for lichen sclerosus et atrophicus?

Answer 21

high potency topical steroids - clobetasol
severe = acitretin

circumcision for males can help

Question 22

How do drug eruptions present?

Answer 22

extensive rash over trunk and limbs predominately in areas of sun exposure

Question 23

How to treat drug eruptions?

Answer 23

oral antihistamines, epi if emergency