Primary Care - Dermatological Flashcards

1
Q

What causes atopic eczema?

A

Overactivity of Th2 cells&raquo_space; increase IL4/5&raquo_space; increased IgE production due to a specific allergen

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2
Q

What is the distribution of eczema?

A

Flexor surfaces

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3
Q

What is the diagnostic criteria for atopic eczema?

A

Itchy skin condition plus 3 of the following:

  • History of itchiness in skin creases
  • History of atopic disease
  • General dry skin
  • Visible flexural eczema
  • Onset in first 2 years of life
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4
Q

What causes eczema herpeticum?

A

Herpes simplex virus type 1 infection superimposed onto active atopic eczema

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5
Q

How does eczema herpeticum present?

A

Widespread vesicular, pustular rash that eventually crusts over
Fever
Lymphadenopathy

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6
Q

What is the treatment for severe eczema herpeticum?

A

IV acyclovir

in mild, treatment unnecessary

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7
Q

What are the first line treatments for eczema?

A

Emollients (500g per week in adults) - creams, lotions, ointments, soap substitutes

Topical steroids - hydrocortisone (mildest) to dermovate (most potent)

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8
Q

How much does one fingertip unit cover?

A

2 palms of area

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9
Q

What are some complications of eczema?

A

Lichenification in adults
Staphylococcal infection = scalded skin syndrome
Eczema herpeticum

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10
Q

How do you treat an infective exacerbation of eczema?

A

Flucloxacillin for 14 days (erythromycin if penicillin allergy)

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11
Q

What genetic mutation is associated with eczema?

A

Filaggrin

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12
Q

Where and how does discoid eczema present?

A

Symmetrical oval erythematous patches/plaques on extremities

Extremely itchy especially at night

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13
Q

What age is discoid eczema more common in?

A

Over 60 years old

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14
Q

How does psoriasis present?

A

Extensor surfaces
Itchy circular symmetrical erythematous plaques with fissuring
Nail bed is affected in 50%

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15
Q

How does guttate psoriasis?

A

Acute symmetrical raindrop circular plaque lesions on trunk/limbs

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16
Q

What is Auspitz’ sign?

A

Bleeding on scraping of a psoriatic lesion

17
Q

What is Kobner’s reaction?

A

Lesions arising from trauma in psoriasis

18
Q

What nail changes are seen in psoriasis?

A

Pitting
Onycholysis
Subungual hyperkeratosis
Oil drop discolouration

19
Q

What causes a relapse of psoriasis?

A

Stress
Smoking and alcohol
NSAIDs
Lithium

20
Q

How else might psoriasis manifest itself?

A

Psoriatic arthritis = polyarthritis, rheumatoid-like

21
Q

What antigens is psoriatic arthritis associated with?

A

HLA-B27 (also ankylosing spondylitis)

HLA-DR4 (also RA and type 1 diabetes)

22
Q

What topical treatments are used for psoriasis?

A

Emollients e.g. diprobase, dermol
Topical vitamin D
Topical steroids

23
Q

What non-topical therapies can be used for psoriasis?

A

Methotrexate
Biologics e.g. infliximab
Phototherapy (UVB/PUVA)