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Dermatology > Rashes > Flashcards

Rashes Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the pathology of eczema/dermatitis/spongiotic disease?

A

Intraepidermal oedema and inflammatory cell infiltration.
WIth or without:
Vesicles/bula, erythematous lesions, scaling/crust, itch, lichenification, erosion, fissuring.

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2
Q

Name the seven types of eczema.

A 
Contact allergic- T4 H/S reaction
Contact irritant- Repeated chemical trauma
Atopic- Genetic and environmental
Drug related- T1 or 4 H/S reaction
Photosensitive- Reaction to UV light. 
Lichen simplex- Physical trauma to skin
Stasis dermatitis- Hydrostatic pressure
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3
Q

Give an example of contact irritant dermatitis.

A

Nappy rash or repeated hand washing

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4
Q

Give an example cause of photosensitive eczema.

A

Light sensitive drugs

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5
Q

What are the two forms drug reaction can take?

A

Immunological and non-immunological

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6
Q

Are non-immunological drug reactions dose dependent?

A

Yes

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7
Q

Give some examples of non-immunological drug reactions.

A 
Eczema
Drug-induced alopecia
Phototoxicity 
Atrophy due to steroids
Psoriasis
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8
Q

What is the most common type of immunological drug eruption?

A

Exanthematous or Type IV

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9
Q

How does an exanthematous drug eruption present?

A

Mild and self limiting.
Wide spread, symmetrical rash which spares mucous membranes.
Itchy with mild fever

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10
Q

Give five drugs commonly associated with exanthematous drug eruptions.

A 
Penicillins 
NSAIDs
Sulphonamides
Erythromycin
Streptomycin
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11
Q

What is an urticarial drug reaction?

A

Type I H/S

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12
Q

How do urticarial drug reactions present?

A

With urticaria- “Hives” and itchy red dermal swelling.

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13
Q

Name some drugs commonly associated with urticarial drug reactions.

A

Beta-lactams antibiotics
Opiates
NSAIDs

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14
Q

What is a pustular/bullous drug eruption?

A

Type II H/S

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15
Q

GIve some examples of pustular/bullous drug eruptions

A

Acneiform- Glucocorticoids

Drug induced bullous pemphigoid- ACEI, penicillin, furosemide

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16
Q

What are fixed drug eruptions?

A

Well demarcated plaques that are red and painful. Associated with: Tetracycline/doxycycline, NSAIDs, paracetamol.

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17
Q

Give some examples of severe cutaneous drug eruptions.

A

Stephen Johnson Syndrome + Toxic Epidermal Necrolysis- Sulfonamides, cephalosporins, NSAIDs.

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18
Q

What gene is eczema associated with?

A

Filaggrin.

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19
Q

How does atopic eczema usually present?

A

Widespread rash (often in flexures) or fissures in ears.

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20
Q

How is atopic eczema diagnosed?

A

Itchiness + three of the following:

Flexure rash/history of, history of atopy (or relative if U4YO), general dry skin, onset before 2YO.

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21
Q

Describe a Type I H/S reaction.

A

IgE mediated which binds mast cells causing histamine release.

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22
Q

Give the symptoms of a Type I H/S reaction

A

Urticaria- Compressible dermal swelling/itchcy lesions
Angiodema- Localised swelling of sub cut tissue of mucosal membranes
Anaphylaxis- SOB and drop in BP

23
Q

What can cause a TI H/S reaction?

A

Allergen such as food or drugs.

24
Q

WHat drugs are commonly associated with TI H?S reaction?

A

Opiated, NSAIDs, beta lactams.

25
Q

How do you diagnose a TI H/S reaction?

A

IgE (RAST) test -> Prick test -> Challenge test

26
Q

How do you manage TI H/S reactions?

A 
Avoidance!
ANtihistamines 
Adrenaline for anaphylaxis 
Steroids for inflammation
Block mast cells 
Immunotherapy
27
Q

Describe a Type II H/S reaction.

A

IgG and IgM mediated.

Important in autoimmunity

28
Q

Give the symptoms of a TII H/S reaction

A

Bula/vesicles/blistering

29
Q

List two drug induced TII H/S reactions and drugs associated with them

A

Acneiform- Glucocorticoid, Li and androgens

Drug induced bullous pemphigoid- ACEI, penicillin, furosemide

30
Q

List three autoimmune TII H/S reactions

A

Pemphigus
Pemphigoid
Dermatitis herpetiformis

31
Q

Describe pemphigus

A

Loss of epithelial adhesion between cells due to IgG against desmoglein 3. Get chicken wire staining.

32
Q

How do you treat pemphigus?

A

Steroids

33
Q

Describe pemphigoid

A

Loss of epithelial connection to basal membrane due to IgG giving sheet lifting of epidermis.

34
Q

Describe a TIII H/S reaction

A

IgG and IgM mediated immune complex reactions

35
Q

What are the symptoms of a TIIIH/S reaction

A

Purpura- Red/Purple discoloration due to blood leakage.

36
Q

What conditions are associated with TIII H/S reaction?

A

Lichenoid conditions (basal layer damage) such as lupus and lichen planus.

37
Q

Describe lichen planus

A

Itchy flat topped papules.

Saw toothed epidermis and pigment drainage to dermis on histology.

38
Q

Describe a TIV H/S reaction

A

T cell mediated and delayed

39
Q

Give three examples of TIV H/S reactions

A

Exanthematous drug reaction
Contact allergy
Psoriasis

40
Q

How does an exanthematous drug reaction present?

A

Wide spread symmetrical rash which spares mucosal membranes.

Itchy and feverish.

41
Q

What drugs are commonly associated with an exanthematous drug reaction?

A

Penicillins, sulphonamides, erythromycin, streptomycin and NSAIDs.

42
Q

How do you test for a contact allergy?

A

Patch testing

43
Q

Give the three main types of psoriasiform rash

A

Psoriasis
Guttate psoriasis
Erythrodermic psoriasis

44
Q

How does psoriasis present?

A

Symmetrical silvery plaques on extensor surfaces.

45
Q

How does guttate psoriasis present?

A

Silvery coin shaped plaques all over the body.

46
Q

How does erythrodermic psoriasis present?

A

Peeling rash across the body that is itchy, painful and can be fatal.

47
Q

How do you treat psoriasis?

A 
Topical VD
Coal Tar
Emollients
Steroids
UVB and PUVA
Immunosuppressants
48
Q

How does rosacea present?

A

Visible blood vessels, pustules and thickening of skin on face and nose. Worse in sunlight.

49
Q

How does acne present?

A

Red inflamed spots on face, back and chest.

50
Q

What are the three categories of acne?

A

Mild, moderate and severe

51
Q

How does mild acne present?

A

Scattered papules and pustules

52
Q

How does moderate acne present?

A

Many papules and pustules

53
Q

How does severe acne present?

A

Cysts and nodules

54
Q

How do you treat acne?

A

Avoid oily substances
Topical vitamin A
ANtibiotics
Benzyl peroxide

Dermatology (10 decks)

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