Rash Flashcards
Under which headings would you describe an individual lesion?
SCAM Size, shape Colour Associated secondary change Morphology, margin
If a lesion is pigmented, the presence of which features increase the likelihood of melanoma?
Asymmetry (lack of minor image in any of the four quadrants)
Irregular Border
Two or more Colours within the lesion
Diameter > 6mm
Differentiate between macule, patch, plaque, papule, nodule, vesicle, pustule and bulla.
Macule- flat lesion less than 1 cm, without elevation or depression
Patch- flat lesion greater than 1 cm, without elevation or depression
Plaque- flat, elevated lesion, usually greater than 1 cm
Papule- elevated, solid lesion less than 1 cm
Nodule- elevated, solid lesion greater than 1 cm
Vesicle- elevated, fluid-filled lesion, usually less than 1 cm
Pustule- elevated, pus-filled lesion, usually less than 1 cm
Bulla- elevated, fluid-filled lesion, usually greater than 1 cm
What are the four main rashes?
maculopapular erythematous petechial/purpuric vesiculo/bullous (look up pics)
Describe a rash consistent with psoriasis.
red demarcated plaques, with secondary crusting, erosions and scale on extensor surfaces
Describe a systematic approach to discussing rashes.
Colour Size Morphology Pattern Distribution
What kind of descriptions would you use for the pattern of a rash?
discrete or confluent? demarcated or indistinct? linear? target? annular (ring-shaped)? discoid?
What kind of descriptions would you use for the distribution of a rash?
generalised/localised central/peripheral flexural/extensor surfaces dermatomal area site-specific
What rash may become secondary to vancomycin therapy?
‘red man syndrome’ - widespread, urticarial erythematous rash
What is Adult-onset Still’s disease?
rare systemic autoinflammatory disease characterized by the classic triad of fevers, joint pain, and a distinctive salmon-coloured bumpy rash which only appears when pyrexial
What is the word you would use to describe someone who is red all over?
erythroderma
Name some conditions which present with erythroderma.
psoriasis erythroderma eczema pityriasis rubra pilaris cutaneous adverse drug reaction cutaneous lymphoma
How does cutaneous lupus typically present?
annular patchy rash or discoid plaque type
Name three drugs which may worsen psoriasis.
antimalarials, B blockers, lithium
What is the prevalence of psoriatic arthritis among patients with psoriasis?
5-30%
Which areas are important to examine in a patient with suspected psoriasis?
flexures, nails, scalp, joints, genital regions, post-auricular regions
Which nail changes are associated with psoriasis?
pitting, onycholysis, subungual hyperkeratosis, leukonychia, oil drop
What are the six different types of psoriasis?
plaque, guttate, flexural, palmoplantar, pustular, erythrodermic
What often triggers guttate psoriasis?
streptococcal throat infections
How does guttate psoriasis present?
usually seen in children and adolescents
numerous small red patches develop on trunk, often clears in a few months but plaque psoriasis may develop later
Describe the presentation of flexural psoriasis.
submammary axillary and anogenital folds - sharply demarcated, glistening salmon pink in colour, can have superimposed candida
Which type of psoriasis can present with significant scaling and painful fissures of palms and soles?
palmoplantar
How does pustular psoriasis present?
localised palmoplantar pustulosis (recalcitrant, multiple sterile pustules on palms and soles) or generalised pustular psoriasis which is an emergency
What is the most common arthropathy in psoriatic arthritis?
asymmetric mono or oligoarthritis
