Term
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Definition
- Common, benign
- Usually asymptomatic
- Distinctive skin eruption that may be viral in origin
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Term
Pityriasis Rosea- HISTORY |
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Definition
- Some evidence viral in origin
- Small epidemics have occurred in fraternity house and military bases
- 20% patients have a recent history of acute infection with fatigue, headache, sore throat, lymphadenitis and fever
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Term
Pityriasis Rosea- SKIN FINDINGS |
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Definition
- Herald Patch: a single 2 to 10 cm oval lesion most frequently located on the trunk
- Within 7-14 days, smaller lesions appear and reach their maximum number in 1-2 weeks
- Can be concentrated in lower abdomen
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Term
Pityriasis Rosea- SKIN FINDINGS |
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Definition
- Plaques are pink in Caucasian and dark brown in African Americans
- Plaques oriented along skin lines on the back look like drooping tree branches
- Number of lesions vary from a few to hundreds
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Term
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Definition
- Secondary Syphillis (especially if herald's patch is missing)
- Tinea versicolor (can be ruled out with KOH examination)
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Term
Pityriasis Rosea- TREATMENT |
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Definition
- Disease clears spontaneously in 1-2 months
- Extensive cases with intense itching: responds to 1-2 week course of prednisone
- Direct sun exposure hastens solution
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Term
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Definition
- Distinctive, inflammatory cutaneous and mucous membrance reaction
- Course is variable and unpredictable
- Itching is variable in intensity
- May occur as a generalized disease or may be secondary to drug
- Severe oral lichen planus may generate to squamous cell carcinoma (3%) of cases
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Term
Linus Planus-SKIN FINDINGS |
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Definition
- Primary lesion is 2-10mm, flat topped papule with an irregular, angulated border
- Surface has a lacy, reticular pattern of criss-crossed, whitish lines (Wickhams striae)
- 5 "P's": pruritic, planar (flat-topped), polyangular, purple, papules
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Term
Linus Planus-SKIN FINDINGS |
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Definition
- Located in flexor surfaces of the writs and forearms, legs immediately above ankles and then lumbar region
- Oral lichen planus: buccal mucosa
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Term
Linus Planus-LAB FINDINGS |
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Definition
Anti-hepatic C virus antibodies are detected inabout 16% of patients with the cutaneous form and about 30% with the oral form
- Order a Hep-C test
- Order a LFT
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Term
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Definition
- Psoriasis
- Pityriasis Rosea
- Leukoplakia
- Candidiasis
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Term
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Definition
- Antihistamines for pruritis
- Group I-III topical steroids for initial localized disease
- Prednisone is administered for generalized disease
- Orabase (steroid and adhesive base)
- Azmacort
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Term
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Definition
- Papulosquamous diseases
- Skin, nails and joints
- MANY forms: common presentation is scaly plaques involving the elbows, knees and scalp
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Term
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Definition
- 1-3% of population worldwide
- Etiology unknown
- Genetic transmission
- Men and women equally affected
- Condition is lifelong and characterized by chronic, recurrent exacerbations and remissions
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Term
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Definition
- Stress may precipitate an episode
- Can develop at a site of physical trauma
- Worse in dry winter weather
- Amount of pruritus varies
- Psoriatic arthritis occurs in 5-8% of population with psoriasis
- Precipitating drugs: Lithium, beta-blockers, anti-malarials and systemic steroids
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Term
Psoriasis- SKIN FINDINGS: Plaque |
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Definition
- Begins at red, scaly, papule that forms into round to oval plaques
- Effects extensor surfaces (usually spares palms, soles, and face)
- Deep rich red color is a characteristic feature
- Scale is adherent and silvery white: when removed, "Auspitz's sign"
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Term
Guttate Psoriasis-SKIN FINDINGS |
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Definition
- Associated with Group A strep
- Sudden appearance of scaly papules
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Term
Guttate Psoriasis-SKIN FINDINGS: Localized Pustular |
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Definition
- Localized reccurent crops of small, sterile pustules evolve from the red base
- Often on palms and soles (palmoplantar pustulosis)
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Term
Erythrodermic Psoriasis: SKIN FINDINGS |
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Definition
Total body redness: SERIOUS disease |
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Term
Psoriasis: SKIN FINDINGS: Nail |
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Definition
- Pitting, oncholysis (seperation of nail from nail bed)
- Nail dystrophy
- Oil spot lesion
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Term
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Definition
- Eczema
- Seborrheic Dermatitis
- Syphillis
- Pityriasis Rosea
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Term
Psoriasis: TREATMENT- Topical |
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Definition
- Calcipotriol (Vitamin D)
- Topical steroids (fast but temporary)
- Tazorac gel
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Term
Psoriasis: TREATMENT- Phototherapy |
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Definition
- Better, worse, stays the same
- Few times/week
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Term
Psoriasis: SYSTEMIC TREATMENT |
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Definition
- Indicated for >20% body surface
- Usually managed by a dermatologist
- Rotational approach to therapy minimizes the long term toxic effects
- MTX: gold standard (erythrodermic and generalized pustular psoriasis) -Needs folic acid cotx, CBC, LFT monitoring
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Term
Psoriasis: SYSTEMIC TREATMENT |
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Definition
- Cyclosporin (Neoral): Severe inflammatory psoriasis (BP monitoring, CBC, CR)
- Acitretin (Soriatane): generalized pustular and erythrodermic psoriasis (teratogenicity, hepatitis, pancreatitis)
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Term
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Definition
- Infection with Treponema Pallidum
- Untreated can lead to 3 stages: Primary, Secondary, Latent or Rare 3 stage
- More common in males
- 20-40 Y/O
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Term
Secondary Syphilis-SKIN FINDINGS |
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Definition
- 6 weeks after chancre (original painless sore) appears
- Mucucutaneous lesions, influencza like syndrome
- Stage lasts 2-10 weeks
- Syphilis in this stage is confused with numerous other lesions
- Color of lesion: coppery
- Lesions appear on palms or soles of feet in most cases
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Term
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Definition
- Corkscrew-rotation motility of a small, spiral spirochete
- RPR, VDRL
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Term
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Definition
- Pityriasis Rosea
- Guttate psoriasis
- Lichen Planus
- Tinea Versicolor
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Term
Secondary Syphilis-TREATMENT |
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Definition
- Early disease: Benzathine penicillin G (2.4 million U IM)
- Late disease: as above but q week X 3
- Penicillin allergic: doxy or tetra
- Successful therapy: falling RPR titer
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Term
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Definition
- Exceedingly pruritic, round lesions of eczematous inflammation
- Adults often affected
- Usually begins as few lesions then multiple with no particular pattern
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Term
Nummular Eczema-SKIN FINDINGS and DDX |
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Definition
Demarcated, scaling roundplaques
DDX: Psoriasis and tinea |
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Term
Nummular Eczema-TREATMENT |
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Definition
- Topical Steroids: improve and then recur with steroid withdrawal
- Unpredictable
- One of most difficult forms to treat
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