Skin Disorders - Inflammatory Flashcards
1
Q
Eczema
A
- rash with scaling and crusting
- atopic dermatitis and contact dermatitis
- other types include nummulite dermatitis, dishydrotic dermatitis, pellagra…
- epidermal spongiosis, exocytosis
- Principles of Therapy - restore epidermal barrier with moisturizer, corticosteroids, address behavioural component, test for and eliminate irritants or allergens
2
Q
Atopic dermatitis
A
- heritable tendency
- associated with asthma, allergic rhinitis and urticaria (atopic diathesis)
- especially on the flexores (antecubital, popliteal)
- epidermal spongiosis, exocytosis
- Principles of Therapy - restore epidermal barrier with moisturizer, corticosteroids, address behavioural component, test for and eliminate irritants or allergens
3
Q
Contact dermatitis
A
- allergic (delayed hypersensitivity)
- irritant contact dermatitis —-> direct action of irritant
- epidermal spongiosis, exocytosis
- Principles of Therapy - restore epidermal barrier with moisturizer, corticosteroids, address behavioural component, test for and eliminate irritants or allergens
4
Q
Psoriasis
A
- inflammatory disorder of keratinocytes, high epidermal turnover (23 days to 3-5 days)
- erythematous plaques with silvery scale - esp. elbows and knees
- guttate (raindrop), pustular, erythrodermic (total body erythema)
- increased metabolic demands
- pitting of nails
- psoriatic arthritis
- Histology: acanthosis, neutrophils in stratum corneum, microabscesses in epidermis, dermal lymphocytes
- Principles of Therapy: topical corticosteroids, Vitamin A and D analogues, UV light, immunosuppressants, TNF-alpha blockade
5
Q
Lichen Planus
A
- pruritic, purple, polygonal, polymorphous papules (4 Ps)
- ventral wrists, lacy whitish oral lesions (Wickham’s striae)
- associated with Hep C sometimes
- Histology: band like lymphocyte infiltrate at DE junction
- Principles of Therapy: corticosteroids, metronidazole
6
Q
Acne Vulgaris
A
- androgens
- open comedones - blackheads (keratin and sebum) MILD
- closed comedones - whiteheads MILD
- erythematous papules and pustules MODERATE
- cysts, nodules, scars SEVERE
- teenagers and young adults
- Histology: follicular plugging with keratin and follicular inflammation
- Principles of Therapy: antimicrobials, exfoliation (benzoyl peroxide, salicylic acid, retinoids), oral retinoids (isotretinoin —-> teratogenic)
7
Q
Rosacea
A
- older adults —-> sun, alcohol, exercise
- midface, variable erythema, papules, pustules, telangiectasia, no comedones
- ethology unknown —- possibly Demodex mites in association with cutaneous bacteria
- rhinophyma
- Principles of Therapy: avoidance of triggers, anti-fungals, antibiotics for pustular and popular lesions
8
Q
Pseudofollicultis barbae
A
- inflammation of skin due to penetration by the tip of a cut hair
- African ancestry
9
Q
Pityriasis Rosea
A
- larger herald patch (2-10 cm) then few days or weeks later —-> multiple smaller slightly scaling pruritic oval plaques in Christmas Tree pattern salmon coloured in white people, grey or purplish in browns
- Spring and Fall, no virus proven
- lasts 2 months, then resolves, rarely recurrent
- Histology: epidermal spongiosis
- Principles of Therapy: corticosteroids, questionable benefits from UV and erythromycin
10
Q
Systemic Lupus Erythematosus
A
- photosensitivity, butterfly erythema, ANA (anti nuclear antibodies), renal disease
- Skin Histology: vacuolization of basal layer (bubbly), granular IgG along basement membrane
- Principles of Therapy: photoprotection, corticosteroids, antimalarials, immunosuppressants - matched to severity of disease
11
Q
Discoid Lupus
A
- can be only finding, but also found in SLE
- discoid lesions - circular, with red periphery and atrophic or scarred center (biopsy periphery)
- Skin Histology: vacuolization of basal layer (bubbly), granular IgG along basement membrane
- Principles of Therapy: photoprotection, corticosteroids, antimalarials, immunosuppressants - matched to severity of disease
