Shared Flashcard Set

Details

PA 303
Derm-Lecture 2
33
Medical
Graduate
08/26/2010

Additional Medical Flashcards

 


 

Cards

Term
Pityriasis Rosea
Definition
  • Common, benign
  • Usually asymptomatic
  • Distinctive skin eruption that may be viral in origin
Term
Pityriasis Rosea- HISTORY
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
Term
Pityriasis Rosea- SKIN FINDINGS
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
Term
Pityriasis Rosea- SKIN FINDINGS
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
Term
Pityriasis Rosea- DDX
Definition
  • Secondary Syphillis (especially if herald's patch is missing)
  • Tinea versicolor (can be ruled out with KOH examination)
Term
Pityriasis Rosea- TREATMENT
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
Term
Linus Planus
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
Term
Linus Planus-SKIN FINDINGS
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
Term
Linus Planus-SKIN FINDINGS
Definition
  • Located in flexor surfaces of the writs and forearms, legs immediately above ankles and then lumbar region
  • Oral lichen planus: buccal mucosa
Term
Linus Planus-LAB FINDINGS
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
Term
Linus Planus-DDX
Definition
  • Psoriasis
  • Pityriasis Rosea
  • Leukoplakia
  • Candidiasis
Term
Linus Planus-TREATMENT
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
Term
Psoriasis
Definition
  • Papulosquamous diseases
  • Skin, nails and joints
  • MANY forms: common presentation is scaly plaques involving the elbows, knees and scalp
Term
Psoriasis-HISTORY
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
Term
Psoriasis-HISTORY
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
Term
Psoriasis- SKIN FINDINGS: Plaque
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"
Term
Guttate Psoriasis-SKIN FINDINGS
Definition
  • Associated with Group A strep
  • Sudden appearance of scaly papules
Term
Guttate Psoriasis-SKIN FINDINGS: Localized Pustular
Definition
  • Localized reccurent crops of small, sterile pustules evolve from the red base
  • Often on palms and soles (palmoplantar pustulosis)

 

Term
Erythrodermic Psoriasis: SKIN FINDINGS
Definition
Total body redness: SERIOUS disease
Term
Psoriasis: SKIN FINDINGS: Nail
Definition
  • Pitting, oncholysis (seperation of nail from nail bed)
  • Nail dystrophy
  • Oil spot lesion
Term
Psoriasis: DDX
Definition
  • Eczema
  • Seborrheic Dermatitis
  • Syphillis
  • Pityriasis Rosea
Term
Psoriasis: TREATMENT- Topical
Definition
  • Calcipotriol (Vitamin D)
  • Topical steroids (fast but temporary)
  • Tazorac gel
Term
Psoriasis: TREATMENT- Phototherapy
Definition
  • Better, worse, stays the same
  • Few times/week
Term
Psoriasis: SYSTEMIC TREATMENT
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
Term
Psoriasis: SYSTEMIC TREATMENT
Definition
  • Cyclosporin (Neoral): Severe inflammatory psoriasis (BP monitoring, CBC, CR)
  • Acitretin (Soriatane): generalized pustular and erythrodermic psoriasis (teratogenicity, hepatitis, pancreatitis)
Term
Secondary Syphilis
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
Term
Secondary Syphilis-SKIN FINDINGS
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
Term
Secondary Syphilis-LAB
Definition
  • Corkscrew-rotation motility of a small, spiral spirochete
  • RPR, VDRL
Term
Secondary Syphilis-DDX
Definition
  • Pityriasis Rosea
  • Guttate psoriasis
  • Lichen Planus
  • Tinea Versicolor
Term
Secondary Syphilis-TREATMENT
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
Term
Nummular Eczema
Definition
  • Exceedingly pruritic, round lesions of eczematous inflammation
  • Adults often affected
  • Usually begins as few lesions then multiple with no particular pattern

 

Term
Nummular Eczema-SKIN FINDINGS and DDX
Definition

Demarcated, scaling roundplaques

 

 

DDX: Psoriasis and tinea

Term
Nummular Eczema-TREATMENT
Definition
  • Topical Steroids: improve and then recur with steroid withdrawal
  • Unpredictable
  • One of most difficult forms to treat
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