Rashes Flashcards
T/F: eczema and dermatitis can be used interchangeably to describe inflammatory skin disease
True
types of eczema?
endogenous
- atopic
- seborrheic
- stasis
- discoid
- asteatotic
- pompholyx
- lichen simplex
- photosensitive
exogenous: allergic, irritant
__ % of global population suffer from eczema
10
atopic eczema is associated with..
kids <2 and other atopy
stasis and asteatotic (seasonal-winter) associated with…
elderly
pompholyx is associated with
adults
atopic eczema pathophysiology?
abnormalities in skin barrier function, combined with abnormalities of immunity possibly caused by filaggrin deficiency
s/s of atopic eczema?
pruritus, erythema, scaling, FLEXURAL distribution, dryness, lichenification (skin thickening) in chronic disease
sites for atopic eczema?
back of knees, ankles, wrists, inside of elbows, neck, eyes, genitals
main complication of atopic eczema?
2y infection due to scratching by staph a, eczema herpeticum (multiple small blisters/ monomorphic punched out crusted papules)
aetiology of seborrheic eczema?
malassezia yeast, HIV, parkinsons
s/s of seborrheic eczema?
greasy body areas, scaling & erythema, around nose, medial eyebrows, ear canals, dandruff
mx of seborrheic eczema?
anti-fungals/ steroids
T/F: stasis eczema more common in people with varicose veins
T
s/s of stasis eczema
inner calf, associated with signs of venous HT e.g. hemoiderin deposits
s/s of discoid eczema
well demarcated scaly patches with small vesicles affecting limbs and torso, itchy
T/F: asteatotic eczema is mildly itchy and occurs at lower back and lower legs
F: intensely itchy but site is correct
causes of pompholyx eczema?
contact dermatitis, endogenous, cold/dry weather, frequent hand washing
s/s of hand/foot eczema/pompholyx?
blistering/ bumpy spots on hands, dry shape skin- patch testing recommended
lichen simplex eczema aetiology ?
repeated rubbing/scratching- may be due to emotional stress present
s/s of lichen simplex
thickened skin and lichneified- common at nape of neck, outer calves, anogenital area
photosensitive eczema some on with exposure to sunlight- what are its s/s?
confined to exposed areas- behind ears, cut off at collar- usually rash but may be blistering or scaly
what are the mainstays of treatments for endogenous eczema
emollients, avoid irritant, topical steroids
phototherapy or systemic immunosuppressants for severe disease
what is exogenous eczema
inflammatory skin reaction due to contact with a substance or irritant
pathophysiology for allergic exogenous eczema
Langerhans cells react to antigen which is presented to T-helper cells in dermis > migration to lymph nodes> antigen presentation amplified
common causes of allergic exogenous eczema and irritant EE
fragrance, rubber, metals, chemicals, medications
irritants- usually cleaning products
T/F: exogenous eczema s/s are similar to endogenous
T: erythema, scaling, itch- usually pattern follows exposure
retinoid is rx for what?
chronic cases of exogenous eczema
what is psoriasis
chronic inflammatory papule-squamous disorder characterised by well demarcated red, scaly plaques
bimodal pattern for psoriasis is…
1st- 16-22, 2nd wave: 55-60
pathophysiology of psoriasis
skin is inflamed and hyperpoliferates (complement mediated attack on keratin layer causing epidermal hyperplasia)
4 types of psoriasis…
chronic plaque psoriasis (psoriasis vulgaris)- most common
guttae- rain-drop psoriasis (oval plaques), trunk, 2 weeks post sore throat
erythrodermic- wide-spread, sterile pustules, malaise, pyrexia
palmoplantar pustular- hands and feet, heavy smokers
which type of psoriasis is life-threatening
erythrodermic
what is psoriasis vulgarisms classic presentation?
symmetrical, pink, well demarcated plaques- may have silver scale- on EXTENSORS (elbows and knees)
what is the Kobner phenomenon
new plaques forming at sites of skin trauma e.g. stretch marks
tiny bleeding spots is called..
Auspitz sign
T/F: psoriasis may have nail signs
T- onchylosis, nail pitting, hyperkeratosis
mx for psoriasis?
vitD analogues, emollients, steroids, coal tar, phototherapy (UVB/ PUVA)
name an example of a vitamin D analogue
calcipotrol
what is lichenoid
chronic inflammatory rash of unknown cause
sites lichenoid affects?
wrists and forearms, shins and ankles
pathophysiology of lichenoid?
t-cell mediated inflammation targeting proteins in skin and keratinocytes*
what are the types of lichenoid
lichenoid planes
lichenoid drug eruption
which drugs trigger lichenoid?
BB, ACEI, gold
telltale histological sign of lichenoid?
sawtooth acanthosis and hypergranulosis
s/s of lichenoid
violaceous flat-topped shiny papules, Wickam’s striae (lace like), itchy
may have mucosal involvement- white streaks on tongue
T/F: lichenoid may also kobnerize
T
mx for lichenoid?
resolves within 12-18months, emollients, corticosteroids, phototherapy
check for drug precipitant
