Psoriasis etc Flashcards
- *itch, viscious cycle, often itch before rash
-**spares groid, axilla -
atopic triad:
atopic derm
allergic rhinitis
asthma
-extensor, face neck in kids
-*flexor in adults
-important: *early age of onset, fam hx, xerosis (dry skin) - various: scale to papule to vesicle
Atopic Dermatitis/Eczema
Seb Derm doesn’t spare groin, axilla
Complications of Atopic Derm/Eczema
Lichenification = thickened skin due to itching
Excoriations => 2ndary cellulitis (staph)
Fissures on palms and soles
Tx of Atopic Derm/Eczema
avoid: triggers itching, bathing Antihistamines for itch Brief low potency steroid (avoid face) Use moisturizer
Group 1 steroid
super high (deprotene)
Group 2 and 3
2: high lidex derm only
3: diprosole
Group 4 and 5
Primary care
4: medium (kenalog oint)
5: lower medium (kenalog cream)
Group 6 and 7
6: low (aristocort)
7: least (OTC hydrocortisone)
- looks like Atopic Derm (AD)
- psychological itching
- Dry leathery
- goes away when stop itching
- topical stroids/moist
- TCAs (tricyclics?) and neuroleptics
Lichen Simplex Chronicus
- vesicles on sides of fingers, palms, soles
- INTENSE itch
- dries and cracks
- spont remission after 2-3 wks
- topical steroids
DisHidrotic Eczema (pompholyx)
Atopic means
itches
- benign, genetic
- TONS of red/brown papules
- outer upper arms, thighs, cheeks, upper back
- AHA
Keratosis Pilaris
-delayed-hypersensitivity (Type IV)
-poison ivy, nickel, latex,
NEOSPORIN/NEOMYCIN
Allergic Contact Dermatitis
-acute, chronic
-water, detergents, friction
-80% / occupational
-Tx:
stop irritant
decrease hand-washing
lots of bland emollient (vaseline, aquaphor)
topical steroid
Irritant Contact Derm
- chronic inflammation
- affects infants + teens, adults
- infants: yellow-greasy, scales on scalp, diaper, axilla
- adults: greasy scales, yellow-red macules, patches, papules
- head has more seb glands: nasolabial, base of eyelash, eyebrows, behind ear and meatus, sternum, upper back
Seborrheic Derm (SD)
phyrosporum/malesseria cause
seb derm and Tinia Versicolor
Tx of seb derm
Anti-dandruf shampoo
Ketoconazol cream
Severe: oral ketoconasol or diflucan
4 Ps + wrists/hands and mouth (50%) purple/pink pruritic polygonal papule (planar) White lines
Lichen Planus
Wickham’s striae
- very silvery scales
- Auspitz sign
- Koebner Phenomenon
- pitting of nails/separation (jnts and muc memr can be affected)
- better with UV
- can develop arthritis
- elbows, knees and scalp are most
Psoriasis
Tx of Psoriasis
- always to derm
- ultra/super high steroid
- keratolytic agents (anthralin)
- calcipotriol (vit D3 derivative)
- phototherapy (UVA/UVB) + pUVA
- oral: methotrexate, retinoids
*starts with 1 herald patch
*oval
*benign
- mild or no pruritis
- self-limited (1-2 months)
- cigarette ppr on some plaques (scaly)
Tx:
- medium (Gr5) topical conticosteroid for itch
- antihistamine for itch
* SUN/no tx
Pityriasis Rosea
Which conditions spare groin/axilla or groin?
Eczema/Atopic derm spares groin and axilla
Tinia Cruris spares groin
Seb derm doesn’t spare groin/axilla
which condition doesn’t spare groin/axilla
seb derm
Malessezia sp (fungal) causes
Seb Derm and Tinia Versicolor
Seb Derm is what category of skin disorder?
Papulosquamous
often itches before rash appears
eczema/atopic derm
Super high potency steroid
Diprolene (Beta…)
high steroid
lidex (derm only)
Intermediate steroid
hydrocortisone VALERATE 0.2% (vs acetate)
low potency steroid
Kenalog, Aristocort A
Hydrocortisone ACETATE 2.5%
Hydrocotisone acetate 1% OTC
Thick and scaly like Psoriasis
Lichen Planus
Tx for Lichen Planus
Oral/topical Medium Potency Steroids
(Hydrocortisone Valerate 0.2%)
- cyclosporine (immune suppressor)
