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PM2 > Week 2 - Common Dermatological Conditions > Flashcards

Week 2 - Common Dermatological Conditions Flashcards

1
Q

Papulosquamous Disorders - PsO

A

A chronic inflammatory disease of the skin characterised by well demarcated erythematous plaques with detachable silver scales

Frequent sites of involvement: sacrum, scalp, nails, umbilical

infrequent sites: face, flexor areas

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2
Q

Psoriasis (PsO)

A
  • Genetic - arising from dysregulation of the immune system
  • Greatly reduced keratinocyte turnover time
  • prevalence = 3%
  • Occur at any age
  • Chronic, relapsing and remitting
  • mild to life threatening
  • associated with metabolic syndromel
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3
Q

PsO - different presentations

A

plaque
guttate
pustular psoriasis
inverse (body folds)

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4
Q

Complications of PsO

A

Psoriatic arthritis
Erthroderma
Koebner phenomenon

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5
Q

Impacts of PsO

A

Psychological
Physical
Social
Economic

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6
Q

Eczema

A

Wide category of non-infective and inflammatory skin disorders that are extremely itchy
- scaling, erythematous macules, papules, vesicales and/or plaques (often poorly defined margins)
- Conditions involce varying degrees of: inflammation, soreness, dryness, erythema, exudation, fissuring

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7
Q

Eczema classification

A

Now considered same as dermatitis

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8
Q

Exogenous vs exogenous eczema

A

Exogenous (dermatitis) - allergic, irritant, photoreactive

Endogenous eczema - asteatotic, atopic, seborrhoeic, discoid, venous (statis), pomphyolix, hand, eyelid

Unclassified - juvenile plantar dermatosis, neurodermatitis

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9
Q

Acute vs chronic eczema

A

Acute - affects epidermis and upper dermis, blistering and weeping, epidermal oedema, eryhtema, intense itching

Chronic - hyperkeratosis more common, lichenification, less weeping and vesiculation, acanthosis

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10
Q

Asteatotic eczema

A
  • Common pruitic condition
  • affects arms, legs, feet and hands
  • elderly patients (80s)
  • drying of skin and loss of lipids
    more chronic in winter, resolving in summer
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11
Q

Nummular eczema

A
  • coin shaped lesions that are symmetrical
  • relapsing and remising condition
  • affects mostly middle ages and elderly patients (unknown)
    Frequently involved sites incl back of hands, extensors surfaces of legs, forearm and hips
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12
Q

Atopic Eczema

A

The itch that rashes
- occurs from 2 months to adulthood
- chronic and relapsing
- strong family history
- the ‘atopic march’
- aetiology unknown but environmental and genetic factors thought ot be involved in conjuction with FLG mutation - skin loses barrier function

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13
Q

Atopic eczema Essential features for Dx

A
  • Puritis
  • eczema (acute, subacute, chronic)
  • Morphology and age-specific patterns:
    Infants and children: face, neck and extensor involvement
    Any age group - current or previous flexural lesions
    -Does not involve groin or axillary areas
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14
Q

Contact Dermatitis - irritant vs allergic

A

ICD - inflammatory reaction to a noxious substance on the skin

ACD - an inflammatory reaction that is immune mediated after multiple exposures to a substance

Majority of CD cases are the result of ICD
CD accounts for 70-90% of all occupational skin diseases

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15
Q

ICD and ACD presentation

A

May present in the foot with a range of features including erthema, scaling, blistering, weeping, fissuring and intense itching
- if prolonged, skin may become lichenified and pigmented

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16
Q

ICD and ACD Assessment

A
  • Good hx within timeline essential
  • Rule out TP as a DDx
  • Plantar area rarely affected unless macerated/damp brocken skin
  • Areas affected should be in contact with allergen or irritant, other areas spared
17
Q

Frequent causes of foot CD

A
  • rubber additives and preservatives
    -topical antibacterial agents - bactriban, neomycin
  • potassium dichromate
  • nickle sulphate
  • tea tree oil
18
Q

Juveline plantar dermatosis

A

Glazed foot
no contact allergy
resistant to steriods
resolves at puberty
aetiology uncertain
- treated with cork insoles

19
Q

Pompholyx

A
  • Variant of eczema characterised by small
  • intensly pruritic
  • may precede eruption
  • always check for tinea
  • associated with hyperhidrosis and nickel allergy
20
Q

Skins Natural defences

A
  1. Desquamation
  2. lower surface pH
  3. fatty layer
  4. langerhans cells
  5. bactericidal/antimicrobial peptides in sweat
  6. natural skin flora
20
Q

Skins Infections

A

Bacteria
Fungi
Viral

20
Q

Failures of natural defences

A
  • due to excessive: heat, moisture, desiccation
  • break in the skin occurs
    Risk factors include
  • age
  • open wounds
  • immunosuppresion
  • pre-existing diseases
    -soiled skin/poor hygiene
  • drugs
20
Q

Skin Infections primary due to:

A

Staph and step

20
Q

Erysipelas

A

Acute infection caused by step
Typical signs = oedema, redness and tenderness
- leg/foot and face = most common

1 attack predisposes to further attacks
recurrant attacks may lead to scarring and blockage of lymphatics

21
Q

Impetigo

A
  • Superficial infection - mainly staph but can be strep
  • most common in children
  • rapid spread of lesions and very contagious
  • presents as blisters which rupture, releasing golden exudate which forms crusts
21
Q

Cellulitis

A

Similar to erythema however;
- lower dermis infected
- more extensive infection
- greater redness, swelling and pain
- similar complications can occur

22
Q

Factors that increase risk to fungal disease

A
  • communal shower/washing facilities
    -occlusion and moisture
  • occupational exposure
  • contact with animals
  • immune status
    -genetics
23
Q

Tinea Pedis symptoms

A

itching
macceration or dry scaling
acute presentation - redness with blistering and weeping
chronic - dull redness with scaling or dusty, dry appearances, less itching, often unnoticed

24
Q

Where to look for TP

A

-interdigital - maceration or scaling
-plantar area - dry powdery appearance or less commonly acute inflammatory eruption
- discoloration of nails

25
Q

Onychomycosis

A

Fungal nail secondary to skin infections
nail is usually traumatized 1st - ordinary it is difficult for fungus to penetrate nail

26
Q

what is verruca Pedis

A

Common skin condition seen in both adults and children
-HPV responsible
- for infection to occur - dermal abrasion and transiently impaired immune system needed to inoculate a keratinocyte
- Have it forever - will have outbreak from immunocompromised

27
Q

What happens on debridement of verruca pedis

A
  • on debridement of the HK, pinpoint bleeding may be seen and interruption of the skin lines
  • pain may be elicited through lateral compression of the plantar lesion
28
Q

Verruca pedis presentations

A
  • Papules merging together to form plaque
  • warts
29
Q
A

PM2 (8 decks)

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