Psoriasis Flashcards
Retinoid
Form of vitamin A
Reduces skin turnover
Fumaric acid ester
Used in psoriasis treatment
Disrupts lymphocytes
distinctive acute skin eruption characterised by small drop-like, salmon-pink papules which usually have a fine scale
Guttate psoriasis
RECENT URTI SECONDARY TO GABHS OFTEN PRECEDES ERUPTION BY 2-3 WEEKS
Which type of psoriasis may be preceded by an URTI caused by Group A beta haemolytic strep?
Guttate psoriasis
Most commonly associated with streptococcal infection?
Guttate psoriasis
Chronic inflammatory disease of the pilosebaceous unit
Acneee
Which bacterium colonises the duct in acne?
P. acnes
Open comedone
Black head
Closed comedone
White head
Acne grading
Mild- scattered papules and pustules, comedones
Moderate - numerous papules, pustules &
mild atrophic scarring
Severe - as above, cysts, nodules and significant scarring
Benzoyl peroxide
Acne topical treatment
-keratolytic and antibacterial
Systemic treatment for Acne
Antibiotics
Isotretinoin (oral retinoid) – effect on sebaceous gland activity. Lot of side effects including initial aggravation of acne
Topical treatment for acne
CET (clindamycin, erythromycin, tetracycline)
Benzoyl peroxide – keratolytic, antibacterial
Topical vitamin A derivatives (retinoid): eg adapalene – drying effect
topical antibiotics – antibacterial and anti-inflammatory
Isotretinoin is an oral retinoid which can be used to treat acne. Name a side effect?
Can cause initial aggravation of acne§
How could you treat flare caused by isotretinoin?
Steroids and dapsone (anti-inflammatory)
What exacerbates rosacea?
Change in temperature
Alcohol
Spicy foods
-you could ask about this when taking a history
Papules, pustules and erythema with no comedones
Rosacea
How to reduce aggravating factors of rosacea?
Reduce aggravating factors:
dietary triggers
sun exposure – wear high factor sunscreen
avoid topical steroids
Management for Rosacea?
Antibiotics: Topical metronidazole Oral tetracycline long term Isotretinoin low dose if severe Telangiectasia : vascular laser Rhinophyma: surgery/ laser shaving
Rhinophyma
Enlarged nose (often in men) associated with Rosacea
Difference between bullous pemphigoid and bullous pemphigus?
Bullous pemphigoiD –
split is Deeper, through DEJ.
PemphiguS –
split more Superficial, intra-epidermal
Bullous pemphigoid and niklosky sign?
Bullous pemphigoid is niklosky sign NEGATIVE
niklosky sign is when you rub skin e.g. with eraser and if positive then blister will form within minutes
Does bullous pemphigoid affect mucosa?
Unlikely
Bullous pemphigoid and areas affected on the body?
localized to one area, or widespread on the trunk and proximal limbs
Pemphigus vulgaris and niklosky sign?
Pemphigus vulgaris is niklosky sign positibe
Pemphigus vulgaris and muscosal involvement?
Mucosal involvement is very common in pemphigus vulgaris
Pemphigus vulgaris
Typically affects scalp, face, axillae, groins
Flaccid vesicles/bullae – thin roofed
Lesions rupture to leave raw areas
Increased infection risk
Nikolsky sign positive
Mucosal involvement (eyes, genitals) : very common
Pemphigus vulgaris prognosis?
Chronic self- limiting course
Duration varies from months to years
Most patients achieve remission on treatment within 3 – 6 months
Pemphigus very high mortality if untreated
Pemphigoid up to 20% mortality I year treated
Investigation for pemphigus vulgaris?
Skin biopsy with direct immunofluorescence
Indirect immunofluorescence
