S4 L2 part 2 Skin Conditions

Question 1

What are a few examples of disease affecting the epidermis?

Answer 1

• Psoriasis
• Vitiligo

Question 2

What are the presenting symptoms of dermatitis?

Answer 2

• Group of inflammatory conditions affecting the epidermis, one is eczema
• Can be inflammed, dry, red, cracked, flaky, thickened and skin pigmentation changes and vesicles and extreme itching

Question 3

What are the symptoms of eczema (atopic dermatitis)?

Answer 3

• Atopic or family history of atopy
• Occurs on flexure areas, e.g back of knees
• Dry thickened itchy areas
• Skin often becomes lichenified and excoriated
• Usually bilateral, made worse by cold and allergies like pets

Question 4

How can we manage eczema?

Answer 4

- Remove trigger factors e.g heat, diet

- Regular emollients

- Intermittent topical steroids for flares

• Sometimes antibiotics, phototherapy, antihistamines (stop itching) and immunosuppressants

Question 5

What are the presenting sympoms of acne vulgaris?

Answer 5

• Mainly affects adolescents, more severe in adulthood
• On face but can spread to neck and back etc
• Individual lesions are centred on the pilosebaceous unit but can all coalesce
• Lots of papules and comedones

Question 6

How can we grade acne?

Answer 6

Question 7

How can we treat acne vulgaris?

Answer 7

Mild: topical anti-acne preparations, lasers and lights

Moderate: antibiotics like tetracyclines or OC pill

Severe: course of oral isotretinoin (reduces sebum production)

Question 8

What are the presenting symptoms of psoriasis?

Answer 8

• Red and scaly plaques with well defined edges. Often silvery
• Plaques found in scalp, elbows and knees mainly (extensor)
• Mild itch but if severe can lead to lichenification, painful cracks and fissures
• When a plaque clears can leave pigmented area
• Can have pitting nails and nail separation
• Common in caucasians, has genetic and autoimmune component

Question 9

What are some things that can aggravate psoriasis and what health conditions is it associated with?

Answer 9

Associated with:

• Coeliacs
• IBS
• Psoriatic arthritis
• T1DM

Question 10

How can we treat psoriasis?

Answer 10

- Avoid smoking, alcohol and maintain optimal weight

- Topical: emollients, corticosteroids, Vit D analogues, salicyclic acid

- Phototherapy

- Systemic agents (severe): methotrexate and corticosteroids (avoided a lot due to withdrawal flares and systemic effects)