-
Eczema
-definition
-Types (3)
- -def: a polymorphic inflammatory reaction pattern involving epidermis and dermis
- -Types
- 1. acute - angry, red, inflamed
- 2. subacute
- 3. chronic - not as red and inflamed
-
Acute Exzema Tx (3)
- -edema
- -vesiculation - (weeping or blister) and severe pruritus
- -Tx:
- 1. steroids
- 2. skin care instructions (e.g. using lotions)
- 3. antihistamines
-
Subacute eczema Tx
- -scaling
- -configuration varies and indistinct borders
- -Tx
- 1. steroids
- 2. Protopic/Elidel (acts like steroids but w/out side-effects)
- 3. skin care instructions (warm shower not hot, moisterize)
-
Chronic Eczeme Tx (4)
- -thickened (lichenified)
- -hypo/hyperpigmented
- -Tx
- 1. break itch-scratch cycle
- 2. steroids (topical or intralesional)
- 3. LN2 (liquid nitrogen)
- 4. excision (if nodular, but not for big ones)
-
Hand Eczema types (5)
- 1. Irritant Contact - caused by repeated exposure to mild irritants like soap, water, heat, friction
- 2. Atopic
- 3. Allergic Contact - test w/ patch test
- 4. Fingertip
- 5. Dyshidrosis - sudden eruption of highly pruritic "tapioca" vesicles on palms and soles
-
Irritant vs Contact dermatitis
- Irritant Contact
- -rxn depends on concentration -rxn depends on sensitization
- -can occur in anyone -occurs in sensitized ppl
- -rash confined to site -rash can spread
- Acute lesions
- -no papules -papules
- Chronic lesions
- -fissuring -No fissuring
-
Atopic Dermatitis
-Definition
-Types
-Triad
- -Definition: chronic relapsing dermatitis assocated w/ pruritis
- -Types: acute, subacute, chronic
- -Triad: asthma, hay fever, eczema
-
Psoriasis
-Types
- Chronic immune mediated inflammatory disease; dry, thick scaly lesions (common in elbows, knees, sacrum, scalp)
- -dermal cells turnover rate much faster than normal
- -Types:
- 1. plaque
- 2. guttate - GABHS
- 3. inverse
- 4. pustular (palmar/plantar)
- 5. erythrodermic-serious
-
Psoriasis
-Buzz words
-Tx
- -Buzz words:
- 1. Silver-scale (micaceous)
- 2. Koebners phenomenon - develops plaque on site of injury
- 3. Auspitz sign - scratch plaque and you get pinpoint bleeding
- 4. "Oil spot" (nail) - looks like yellowish drop of oil on nail
- -Tx: steroids forever cus can never be cured
-
Seborrheic Dermatitis
-Sx
- chronic inflammatory dermatits; worse in pts w/ neurological conditions; "dandruff"
- -Sx: yellow "greasy" scale, yellow-red macules
-
Pityriasis Rosea
-Sx
-Tx
- Asymptomatic skin eruption
- -may be viral in origin
- -starts as single red oval plaque "Herald Patch"
- -1 week later # of smaller plaques forms "Christmas tree" pattern
- -Tx: treat symptomatically
-
Lichen Planus
-5P's of LP
- inflammatory reaction of unknown etiology; can turn SCC in oral lesion
- -"Wickham's Striae" (lacey reticular pattern)
- 1. Pruritic
- 2. Purple
- 3. Papules
- 4. Polygonal
- 5. Planar
-
Granuloma Annulare
-Types (6)
- -benign inflammatory condition
- 1. localized (m/c) - flesh colored papules & annular plaques
- 2. generalized (m/c in adults) - widespread; yellow to purple lesions
- 3. subcutaneous (m/c in children) - firm, non tender nodules
- 4. perforating - superficial umbilicated papules
- 5. arcuate dermal erythema (uncommon)
- 6. actinic annulare
|
|
