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Dermatology Diploma > Rashes in Creases > Flashcards

Rashes in Creases Flashcards

1
Q

What is a good algorithm for symmetrical rashes in creases?

A
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2
Q

What is a good algorithm for asymmetrical rashes in creases?

A
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3
Q

What is a good algorithm for flexural rashes in that are pigmented or skin coloured?

A
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4
Q

Why must one be careful when using steroids on flexural sites?

A

They have a natural occlusive effect making the steroid more potent.

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5
Q

What is thought to be the cause for seborrheic eczema/dermatitis?

A

Malassezia furfur

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6
Q

What is the treatment for Scalp Seborrheic Eczema/Dermatitis?

A
  • Overnight application of olive oil
  • Low potency topical steroids - apply for a few hours for thicker crusts. (SEBCO ointment)
  • Ketoconazole shampoo (leave on for 5 minutes)
    • Initiation: 2-3 times weekly until clear
    • Maintenance: Once every 2 weeks.
  • FOR ITCH: steroid mouse, gel or lotion 2-3 times per week at night for 2-4 weeks. (e.g. Betnovate)
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7
Q

What is the treatment for Adult Seborrheic Dermatitis/Eczema on the skin?

A
  1. Ketoconazole shampoo as a bodywash.
    • Leave on for 5 minutes. Use 3 times weekly for 2 weeks and then as required.
  2. Topical Anti-fungals- Miconazole, Clotrimazole, Ketoconazole.
  3. ITCH
    • Mild to moderate potency steroids - Eumovate
    • Comabined steroid/Antifungal - Daktacort/Resolve Plus.
  4. Calcineurin inhibitors - Pimecrolimus or Tacrolimus for flares and resistant cases.
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8
Q

Is the treatment for Seborrheic Dermatits/Eczema curative or to control?

A

To Control

It is not curable.

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9
Q

What is the treatment for Recalcitract Seborrheic Eczema/Dermatitis?

What should you also investigate for?

A

Oral Itraconazole 200mg Once daily for 7 days

Consider Ix for HIV

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10
Q

What is the treatment for infantile seorrheic eczema?

A
  • Emollients
  • Mild topical corticosteroids
  • Steroid+ Antifungals can be used - rarely needed.
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11
Q

What is this?

A

Infantile Eczema

(Lack of satellite lesions & the fact that it flows together makes it more likely to be eczema)

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12
Q

If a case of infantile eczema or tinea doesn’t clear, what should you consider as a differential diagnosis?

A

Langerhan’s Cell Histiocytosis

  • Accumulation of abnormal histiocytes in the skin and reticuloendothelial system.
  • Yellow brown papules.
  • Scalp often affected.
  • Often have bone pains/bone lumps.
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13
Q

What is this?

A

Contact dermatitis

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14
Q

What is this?

A

Flexural psoriasis

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15
Q

What are 3 causes of intertrigo?

A
  1. Red skin from 2 moist surfaces rubbing together
  2. Cutaneous candidiasis
  3. Seborrhoeic eczema
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16
Q

What is the treatment of flexural psoriasis?

A

Generally resistant

  • Hygeine measures
  • Vitamin D Analogues - test patch first as it might irritate.
  • Combined topical steroids/antifungal
  • Calcineurin Inhibitors
17
Q

What is the cause of erythrasma?

A

Corynebacterium Minutissimum

18
Q

What colour does Erythrasma (Corynebacterium) go under a wood’s light?

19
Q

What is the treatment for Erythrasma?

A
  • Antibacterial washes
  • Topicals - clindamycin & Fusidic acid.
  • Resistant - oral erythromycin or doxycycline.
20
Q

What is this?

A

Tinea Cruris

(Raised erythematous scaly border)

Satellite lesions are NOT seen unlike in Candidiasis.

21
Q

What is this?

A

Candida infection

(Satelite lesions in candida infection)

22
Q

What is the treatment for candida infection?

A
  • General hygiene and keep dry.
  • Clotrimazole cream
  • For severe cases oral itraconazole may be required.
23
Q

What is the treatment for tinea cruris?

A
  • Keep dry
  • Clotrimazole cream twice daily for 2-3 weeks.
  • Oral terbinafine can also be used for 2-3 weeks if needed.
24
Q

What is the treatment for acanthosis nigricans?

A
  • Topical retinoid - Tazarotene gel
  • Pigmanorm - Hydroquionone + RetinA + Hydrocortisone.

The above will not get rid of it but can help lighten the pigmentation.

25
Q

What is this rare genetic disease of blisters in teh groin?

A

Hailey-Hailey Disease

  • Erythematous plaques and flaccid blisters on the neck and intertrigenous areas.
  • Diagnosis - skin biopsy with Direct IMF.
    • H&E histology is very similar to pemphigus vulgaris or Darius Disease.
    • IMF is usually negative.
  • Treatment:
    • Topical antibacterials and antifungal agents.
    • Mild/moderate strength topical steroids are the mainstay of treatment.
    • CO2 Laser.
    • Topical Metronidazole is good for malodorous cases.
26
Q

Hidradenitis Suppuritiva is a disease of what?

A

Of the apocrine sweat glands.

27
Q

HS is more common in which gender?

28
Q

What is the staging system for HS?

A

The Hurley Staging System

  • Hurley I: abscess formation (single or multiple) w/o sinus tracts
  • Hurley II: one or more widely separated recurrent abscesses with tract formation and scars
  • Hurley III: multiple interconnected tracts and abscesses throughout an entire area
29
Q

What is the treatment for HS?

A
  1. Conservative - weight reduction, smoking cessation.
  2. Mild Disease -
    • Clindamycin BD Topical
    • Chlorhexidine washes.
  3. Moderate Disease
    • 1st line - Erythromycin/Doxycycline or Lymecycline
    • 2nd line - Rifampicin and Clindamycin
    • Use for 3-6 months. Monitor LFTs with Rifampicin. Don’t use rifampicine alone.
  4. Adjuncts
    • Yasmin - antiandrogen.
    • Systemic retinoids.
    • Botox
  5. Severe Disease
    • Immunosuppression - ciclosporin, Adalimumab.
    • Surgery
30
Q

What is the treatment for axillary hyperhydrosis?

A
  • Antiperspirant - topical 20% aluminium chloride hexahydrate (Driclor).
  • Topical antichlorinergics - topical glycopyrrolate.
  • Oral therapies
    • Oxybutnin 10mg at night.
    • Propantheline 15-90mg daily.
  • Botulinum Toxin A - 15-20 injections to the axillae.
  • Iontophoresis - electrical current. Machines can be bought.
  • Surgical removal of the sweat glands.
31
Q

What is this?

A

Iontophoresis

Dermatology Diploma (39 decks)

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