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| A chronic disease of apocrine sweat glands found in the axilla, groin, under breasts, etc. that heal w/ scarring? |
| Hidradenitis Suppurativa |
| When does hidradenitis suppurativa occur? |
| Only after puberty |
| What can Hidradenitis Suppurativa form? |
| Sinus tracts |
| Name 6 risk factors of Hidradenitis Suppurativa. |
| 1) Women 2) AA 3) h/o acne 4) Tight, curly hair (ingrown) 5) Obesity 6) Tight clothing |
| Name 5 tx for Hidradenitis Suppurativa. |
|
1) I&D 2) PO or topical abx 3) Bleach baths 4) Laser 5) Accutane |
| A chronic, autoimmune blistering dz that causes subepidermal blisters. |
| Bullous Pemphigoid |
| Describe the pathophysiology of bullous pemphigoid. |
| IgG autoantibodies bind to the basement membrane leading to separation of dermis from epidermis |
| What is the cause of bullous pemphigoid? |
| Unknown |
| How common is bullous pemphigoid? Who does it more commonly occur in? |
| Rare. Onset usu. >65yo, men = women |
| Describe the lesions caused by bullous pemphigoid. |
| Tense bullae that heal /s scarring |
| Where is the most common location of bullous pemphigoid? |
| Fleural surfaces |
| Name 5 tx for bullous pemohighoid. |
| 1) Topical steroids 2) Long-term oral prednisone 3) Tertacycline 4) Methotextrate 5) Immunosuppressants |
| Condition that causes areas of complete depigmentation because melanocytes are destroyed. |
| Vitiligo |
| What is the avg. age of onset of vitiligo? |
| 20yo |
| Describe the visual appearance of areas affected by vitiligo. What are the most common locations on the body? |
| Sharply circumscribed white patches that become confluent. MC face, neck, scalp. |
| What is the cause of vitiligo? |
| Unknown. Autoimmune, some genetic inheritance. |
| Name 7 tx for vitiligo. |
| 1) Topical steroids 2) Topical immunomodulators (protopic, Elidel) 3) UV 4) Laser 5) Oral steroids 6) Depigmentation 7) Surgery |
| An autoimmune blostering d/o associated w/ Celiac's dz. |
| Dermatitis herpetiformis |
| Most common age of dermatitis herpetiformis? |
| 30's |
| Describe the rash of dermatitis herpetiformis. |
| Very pruritic, burning sensation, erythematous excoriated papules or plaques and herpetiform lesions |
| What is the most common location on the body affected by dermatitis herpetiformis? |
| Elbows, knees, and buttock. Palms and soles are spared. |
| How is dermatitis herpetiformis dx? |
| Biopsy |
| What is the tx for dermatitis herpitiformis? |
| 1) Gluten free diet 2) Dapsone |
| What are side effects of dapsone? (4) |
| Hemolysis, methemoglobinemia, peripheral neuropathy, cross rxn w/ sulfa allergy |
| What are complications of dermatitis herpetiformis? |
| lymphoma and intestinal CA |
| Skin condition described as having salmon colored plaques with a thick, silvery scale? |
| Psoriasis |
| What is the etiology of psoriasis? What causes the sx? |
| Autoimmune. Fast turnover of dermal cells - 3 to 5 days (normal 23days) |
| What is the most common location of psoriasis? What is the most common type? |
| Elbows and knees. Plaque psoriasis. |
| Name the 5 types of psoriasis. |
| 1) Plaque 2) Guttate 3) Inverse 4) Pustular 5) Erythrodermic |
| Describe appearance of guttate psoriasis. |
| <1cm "dew drop" plaques all over the body. |
| Who is guttate psoriasis most common in? |
| Young, healthy people. Typicalll /p strep infection. |
| Describe appearance of inverse psoriasis. Where does it typically occur? |
| Moist, "beefy red", not scaly. Occurs in skin folds, axillae, groin. |
| Where does pustular psoriasis typically occur? |
| palms and soles |
| Describe appearance of erythrodermic psoriasis. |
| Generalized erythema and scale. |
| Is psoriasis contagious? |
| No |
| What is the name for psoriasis being triggered after trauma, such as surgery or tattoo? |
| Koebner phenomenon |
| What meds can trigger psoriasis? |
| NSAIDS, Lithium, Inderal, Indomethacin, anti-malarials, beta blockers |
| What complication of psoriasis occurs in 10-30% of sufferers? |
| psoriatic arthritis |
| What are anti-inflammatory tx for psoriasis? |
| Topical and intranasal steroids |
| Name 4 immunosuppresant tx for psoriasis. |
| 1) UV 2) Biologics (Enbrel, Humira, Amevive, Remicade, Raptiva) 3) Methotextrate 4) Cyclosporin |
| What tx for psoriasis helps decrease scale? |
| Vitamin D analogue (Dovonex, Vectical) |
| A skin conditions whose hallmark prodome is a herald patch, a salmon colored 1-2cm round patch. |
| Pityriasis Rosea |
| Who does pityriasis rosea typically affect? Where is the most common location? |
| 15-40yo. Trunk. |
| Describe the secondary eruption of pityriasis rosea. |
| Collarette of fine scale OR Christmas tree pattern that is symmetric and gen. on trunks and extremities |
| What is the cause of pityriasis rosea? When does it most commonly occur? |
| Viral. Spring and Fall. |
| What is the tx for pityriasis rosea? |
| None - self limiting 8-12wks. UV can help, mild topical steroids PRN. |
| What other two conditions that are typically seen together w/ eczema as part of the classic triad? |
| Asthma and allergies |
| With eczema, which typically comes first, the rash or the itch? |
| The itch that rashes |
| Describe the physical appearance of skin affected by eczema. |
| Red papules or plaques with scale, lichenification |
| What part of the body does eczema typically affect in children? |
| Flexural surfaces |
| Describe the appearance of nummular eczema. |
| Annular, coin-shaped lesions |
| What are potential triggers of eczema? |
|
1) Harsh chemicals/soaps 2) Excessive nathing/dry skin 3) Foods that worsen 4) Pet dander 5) Excessive heat |
| Name 4 meds to tx eczema. |
| 1)Topical steroids 2) Topical immunosuppressants (Elidel and Protopic) 3) UV light 4) Antihistamines |
| How common is acne vulgaris? Who is it moct common in? |
| Affects >90% of the population, MC in adolescents |
| What are the 2 mian types of acne lesions? |
| Non-inflammatory and inflammatory |
| What are the 2 types of non-inflammatory acne lesions? |
| Comedones - blackheads (open) and whiteheads (closed) |
| What are the 2 types of inflammatory acne lesions? |
| Papules/pustules (superficial) and cysts/nodules (deep) |
| Name 4 causes of acne vulgaris. |
| 1) Skin cells plug hair follicle 2) Excess sebum 3) Bacteria (P. Acnes) 4) Inflammation |
| What can be used to tx P. Acnes? What is a difficulty with tx it? |
| Topical abx (clindamycin, erythromycin), high resistance - need to use benzoyl peroxide to prevent resistance |
| What acne med. is very teratogenic and prescription requires signing the Ipledge system? |
| Oral isotretinoin (accutane, sotret, claravis, amnesteem) |
| What complication of acne can lead to hospitalization? What causes it? |
| Acne Fulminans. High levels of testosterone and P. acnes |
| Rosacea is a common skin condition that involves __________ and ___________. |
| Erythema, rosacea |
| Name the 4 types of rosacea. |
| 1) Vascular 2) Acne 3) Phymatous 4) Occular |
| What is the most common type of rosacea? Describe its presentation. |
| Vascular, facial redness that spares the periorbital area |
| Describe acne rosacea. |
| Papules and pustules w/ central facial redness and telangiectasias |
| Describe the presentation in phymatous rosacea. |
| Skin thickening and irregular surface |
| Where does phymatous rosacea affect? |
| MC the nose (rhinophyma), also chin, forehead, eyelids |
| What is the tx for phymatous rosacea? |
| Only tx is surgery |
| Describe ocular rosacea. |
| Usu. chronic blepharitis and conjunctivitis, dryness, sting/burning of eyes |
| What triggers rosacea? |
| Sun, alcohol, heat, exercise, spicy foods, alcohol |