Scaling Disorders Flashcards
Psoriasis
pathophys
- hyperproliferation resulting in thick skin and excess scaling
- skin proliferation caused by cytokine release from immune cells
- exacerbationby environmental factors
Psoriasis
affects who?
two peaks of age groups
- 20 to 30 y/o
- 50 to 60 y/o
Psoriasis
Types of Psoriasis
5
- Plaque
- Inverse/Flexural
- Guttate
- Erythrodermic
- Pustular
Psoriasis
Describe appearance of plaque psoriasis
- well-demarcated, scaly, erythematous patches/plaques/papules
- overlying silvery-white scale
- Auspitz sign
- Koebner phenomenon
Psoriasis
define auspitz sign
bleeding after scale removal
Psoriasis
define koebner phenomenon
lesions induced by trauma to skin
Psoriasis
which meds are of signficance when taking pt’s history?
6
- systemic steroids
- beta blockers
- NSAIDs
- lithium
- anti-malarials
- interferons
Psoriasis
important history questions to ask
5
- what meds are you taking?
- do you have joint pain?
- any CV risk factors?
- any changes to your nails?
- any tobacco use or alcohol consumption?
Psoriasis
what types of psoriasis do you use topical steriods? side effects?
- all types
- skin atrophy, hypopigmentation, striae
Psoriasis
when do you supplement Calcipotriene tx? side effects?
- combo w/ topical steroids
- skin irritation, photosensitivity
Psoriasis
what type of psoriasis do you prescribe tazarotene for? use in combo with? side effects?
- plaque-type
- topical corticosteroids
- skin irritation, photosensitivity
Psoriasis
what type of psoriasis to use Coal tar for? side effects?
- plaque type
- skin irritation, ordor, staining of clothes
Psoriasis
when to use Calcineurin inhibitors for psoriasis? side effects?
- off-label use for facial and intertriginous psoriasis
- skin burning, itching
Seborrheic Dermatitis
Pathophys
- increase in sebaceous gland activity + hypersensitivity rxn to Malassezia furfur
Seborrheic Dermatitis
when is this more common? what worsens is?
1 & 3
- fall & winter months
- stress rxn
- HIV pts
- neurologic diseases
Seborrheic Dermatitis
Clinical presentation
- erythematous patches or plaques covered w/ fine white-yellow greasy scales
- typically found on scalp, eyelids, beard, nasolabial folds, chest
- can be associated with burning or pruritis
Seborrheic Dermatitis
Dx
clinical presentation
Seborrheic Dermatitis
tx
scale vs face
- scalp: anti-fungal shampp
- face: antifungal agents +/- low potency topical steroid
Seborrheic Dermatitis
tx for scalp
Ketoconazole 2% or ciclopirox 1%
2-3x wklys
Seborrheic Dermatitis
when to add in topical steroid for scalp infection?
if inflammation is present
Seborrheic Dermatitis
what to use for severe or refractory infections?
oral antifungals
Pityriasis Rosea
Common in who? when?
- older children, young adults
- spring/fall
Pityriasis Rosea
clinical presentation
- Herald patch
- general exanthem 1 to 2 wks later (small, pruritic round/oval erythematous papules or thin plaques w/ collarette of scale in x-mas tree pattern)
- confined to trunk and proximal extremities
Pityriasis Rosea
what is herald patch
solitary, salmon colored macular on trunk
initial lesion of Pityriasis Rosea
Pityriasis Rosea
Dx
clinical
Pityriasis Rosea
tx
- self limiting (4-6 wks)
- topical corticosteroid if needed
Pityriasis Rosea
which topical corticosteroid PRN?
triamcinolone 0.1% cream QD or BID
Intertrigo
pathophys
inflammation of large skin folds
Intertrigo
which pathogen causes complication upon colonization?
Candida yeast
Intertrigo
clinical presentation
- burn is greater than itch
- satellite macules, papules, or pustles around erythema within a skin fold
Intertrigo
Tx
2 tx options
- topical antifungals
- topical anti-inflammatory
Intertrigo
topical antifungal tx
- miconazole, clotrimazole, econazole
- Ketoconazole 2% cream BID
Intertrigo
topical anti-inflammatory tx
- desonide ointment
- hydrocortisone 1% ointment QD to BID
Intertrigo
prevention
- keep area dry, clean, cool
- OTC antifungal powders
