Exam 3 chronic skin infections Flashcards

1
Q

Describe clinical features of psoriasis

A

sharply demarcated erythema usually with thick micaceous scale, auspitz sign, koebner phenomenon

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2
Q

Describe the histopathology of psoriasis

A

Extensive hyperkeratosis and parakeratosis, uniform elongation of the rate ridges, neutrophils swarm to epidermis

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3
Q

Pathogenesis of psoriasis

A

T cell mediated autoimmune disorder: T cells produce cytokines that stimulate keratinocyte proliferation

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4
Q

What other things can psoriasis be confused with, how do you differentiate?

A

Lichen simplex chronicus, nummular eczema, seborrheic dermatitis, tinea corporis; punch biopsy

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5
Q

Common areas of psoriasis

A

elbows, knees, presacral, nails, palms and soles

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6
Q

What are the 4 different kinds of psoriasis?

A

Chronic plaque, inverse (fold areas, only erythema), guttate (after strep, tear drop shaped scaled spots), pustular (small pustules becoming generalized with fever)

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7
Q

Treatment of psoriasis

A

topical agents (steroids, retinoids), Systemic (retinoids, cyclosporin, UVB/narrow band, methotrexate)

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8
Q

What is the main complication of psoriasis

A

psoriatic arthritis

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9
Q

Describe the hallmarks of lichen planus

A

6 P’s: planar, purple, polygonal, pruritic, papules, plaques

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10
Q

How do you diagnose lichen planus?

A

punch biopsy

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11
Q

What is lichen planus often associated with?

A

Hepatitis C

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12
Q

What is the classical form of lichen planus? Describe

A

Linear lichen planus; erythematous to violaceous polygonal papules in the flexor ares (wrist and ankles), Wickham’s striae (white patter in mouth)

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13
Q

Describe the forms of lichen planus

A

Hypertrophic: very thick plaques over lichen planus.
Bullous: blisters that occur under lichen planus (interface dermatitis)
Scalp: lichen planopilaris-scarring alopecia of scalp

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14
Q

What is the treatment of lichen planus

A

may resolve spontaneously in 1-2 years, topical steroids, oral steroids, phototherapy STOP THE DRUG IF IT INDUCED IT

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15
Q

What kinds of drugs can induce lichen planus?

A

thiazide, sulfa related, beta blockers, captopril

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16
Q

What is the classic sign of acute lupus erythematosus

A

butterfly rash across the nose and the cheeks, photosensitive pattern of erythema, joint pain as well

17
Q

What are the three types of lupus erythematosus

A

Acute (pauci-inflammatory interface dermatitis), Subacute (prominent suprabasilar exocytosis of lymphocytes), Discoid (very thick basement membrane)

18
Q

What is the most important lab test for lupus erythematosus? Others?

A

anti-nuclear antibodies; complete blood count, sed rate, liver/kidney tests, UA

19
Q

What are the risk factors of SLE?

A

women>men, ages 14-40, more common in african-americans, hispanics, asians

20
Q

Treatment of SLE?

A

NSAIDs, antimalarials, corticosteroids, immunosuppresants (cyclophosphamide, azathaprine)

21
Q

What triggers SLE

A

Sunlight, medications (anti-seizure, antibiotics, BP rx)

22
Q

What are some non-specific skin lesions associated with lupus?

A

Talangiectasia vasculitis, thrombophlebitis, Reynaud’s; Alopecia, urticaria, mucous membrane, pigment changes