Term
|
Definition
| Idiopathic systemic inflammatory disorder (multisite involved); widespread papulosquamous eruption |
|
|
Term
| Pathogenisis (etiology) of lichen planus |
|
Definition
| Unknown; cellular immune mechanisms primarily involved; activated T-cells (early lesions and appear to target antigenically altered basal cells); (older lesions: suppressor T-cells have been shown to predominate) |
|
|
Term
| Skin lesions of lichen planus |
|
Definition
| Flat-topped (planus), Purple, polygonal, papules or plaques, fine scale, poritic |
|
|
Term
| Oral lesions of lichen planus |
|
Definition
| may appear as erythema or erosive gingivitis |
|
|
Term
|
Definition
| Adults>children, onset rather abrupt, itching (often severe) results in flat lesion, painful erosions of mucous membrane, lichen planus-like durg eruptions |
|
|
Term
| Physical exam of lichen planus |
|
Definition
| Primary lesion (purple, polygonal, flat-topped papule), Wickham's striae (fine reticulate pattern of white lines), Wrists and ankles - any area may be affected (palms, soles, and genitalia); few papules or innumerable generalized lesions; residual hyperpigmentation; mucous membrane common/sole manifestations (larynx, esophagus, genitalia) |
|
|
Term
| Oral findings of lichen planus |
|
Definition
| Buccal mucosa, erosive gingivostomatitis |
|
|
Term
| Differential diagnosis of lichen planus |
|
Definition
| Psoriasis, Tinea infections, Pityriasis rosea, discoid lupus erythematous, drug eruption, sarcoidosis, GVHD |
|
|
Term
| Histology of Lichen planus |
|
Definition
| Hyperkeratosis, acanthosis, dyskeratosis, intense band-like inflammatory infiltrate; hypergranulosis (below stratum corneum); basal cell liquefaction and destruction |
|
|
Term
| Vulvovaginal lichen planus (VVLP) |
|
Definition
| Painful erosions and desquamation of vulva and vagine, onset 5th-6th decade, duraction: decades; recurrent yeast or HSV infections; make sure connect symptoms to get correct diagnosis |
|
|
Term
| Therapy for lichen planus |
|
Definition
| Nonspecific and often unsuccessful, inflammatory reaction is suppresed w/ steroids, topical and systemic preparations |
|
|
Term
| LP and cicatricial conjunctivitis |
|
Definition
| Indistinguishable from other forms of cicatricial conjunctivitis, 11 new and 18 published, all had other mucosal sites; d/dx: pemphigoid, Stevens Johnson, atopic keratoconjunctivitis, tx: corticosteroid or cyclosporine drops |
|
|
Term
| Secondary syphilis definition |
|
Definition
| Inflammatory response in skin and mucous membranes |
|
|
Term
| Pathogenesis of secondary syphilis |
|
Definition
| hematogenously disseminated traponema pallidum spirochete; highly contagious at this stage |
|
|
Term
| history of secondary syphilis |
|
Definition
| eruption starts 6-12 weeks after appearance of primary chancre; chancre is usually healed by time secondary phase begins (completely asymptomatic); systemic symptoms: fever, headache, myalgias, arthralgias, sore throat, and malaise |
|
|
Term
| Physical exam of secondary syphilis |
|
Definition
"Great imitator" may appear as macules, nonscaling papules, and annular plaques; scaling papules and plaques; and occasionally even as pustules or nodules
Lesions are freq red-brown or yellowish
Generalized eruption; palms and soles
Mucous membrane: mucous patches of condyloma lata
|
|
|
Term
| Laboratory and biopsy of secondary syphilis |
|
Definition
Dark field positive for spirochetes (not used in oral cavity)
Serologic tests for VDRL and RPR |
|
|
Term
| Therapy for secondary syphilis |
|
Definition
| Intramuscular benzathine penicillin 2.4 mil units; tetracycline or doxycycline for patients allergic to penicillin |
|
|
Term
|
Definition
| Inflammatory eruption; increased epidermal proliferation, accumulation of stratum corneum |
|
|
Term
| Typical distribution of psoriasis |
|
Definition
| Palms, knees, scalp, plantar, elbows, shins |
|
|
Term
| Pathogenesis of psoriasis |
|
Definition
| Genetic predisposition; unknown precipitating factors (unmask); an increased number of dividing cells in the epidermis (keratinocytes); cellular turnover is increased 7 fold and decreased from normal 28 days to 2 or 4 days; cells accumulate fast --> characteristic scale |
|
|
Term
|
Definition
| May occur at any age, onset is usually gradual, positive family history in 1/3 of patients; precipitated by infection, trauma or stress; few drugs will aggravate (lithium and beta blockers) |
|
|
Term
| Systemic considerations of psoriasis |
|
Definition
| Obesity: increased risk of onset of psoriasis, increased body S.A., increased risk of psoriatic arthritic (PA), increased risk of CVD; dramatic response of psoriasis and PsA to treatment with agents that target tumor necrosis factor (TNF) and TNF has strong assoc w/ obesity |
|
|
Term
| Physical exam of psoriasis |
|
Definition
| Sharply demarcated lesions, erythematous papules and plaques, covered by slivery scale, scalp, elbows, and knees are classic sites; intergluteal cleft is common site, rarely entire skin surface affected; nail involvement in 50% of patients |
|
|
Term
| Differential diagnosis for psoriasis |
|
Definition
| Dermatophyte infection, pityriasis rosea, seborrheic dermatitis, eczema |
|
|
Term
| Laboratory and biopsy characteristic changes: |
|
Definition
| Hyperkeratosis, epidermal hyperplasia, dilated tortuous vessels in papillary dermis, inflammatory infiltrate w/ neutrophils extending into epidermis, resembles geographic tongue |
|
|
Term
| Goals of therapy for psoriasis |
|
Definition
| decrease epidermal proliferation and dermal inflammation, responds to systemic steroids however disease may rebound badly, other therapeutic modalities - methotrexate, Etretinate, PUVA, biologics; topical therapy - topical steroids, topical tars, UV light |
|
|
Term
| Pityriasis rosea definition and pathogenesis |
|
Definition
| An acute, self-limiting, inflammatory dermatosis; unknown etiology; "Herald patch" then generalized eruption; viral etiology suggested by its increased incidence in winter months |
|
|
Term
| Physical exam of pityriasis rosea |
|
Definition
| Oval, minimally elevated, scaling papules and plaques; mainly on trunk; follow the skin lines (chevron pattern on chest and fir-tree pattern on back) |
|
|
Term
| differential diagnosis for pityriasis rosea |
|
Definition
| tinea corporis, psoriasis, lichen planus, secondary syphilis |
|
|
Term
| Lab and biopsy of pityriasis rosea |
|
Definition
|
|
Term
| therapy for pityriasis rosea |
|
Definition
| Usually not necessary, self-limiting disease; moisturizers, antihistamines, and UV light may be beneficial |
|
|
Term
| Atopic dermatitis definition |
|
Definition
| Pruritic condition, acute to subacute eczema w/ papules, vesicles, oozing and crusting; associated with a personal or family history of atopic disease (asthma, allergic rhinitis, atopic dermatitis) |
|
|
Term
| Pathogenesis of atopic dermatitis |
|
Definition
Disturbed immunology: elevated serum IgE, decreased cell-mediated immunity, decrease chemotaxis of mononuclear cells
Abnormal vascular response implicated in etiology |
|
|
Term
| Physical exam of atopic dermatitis |
|
Definition
| Infantile: acute to subacute eczema w/ papules, vesicles, oozing and crusting the head, diaper area, and extensor surfaces of extremities; school age: chronic dermatitis w/ lichenification and scaling; adult: neck, face, upper chest and antecubital and popliteal fossae; generally dry skin, an infraorbital fold, and increased linear markings on the palms |
|
|
Term
| Laboratory and biopsy of atopic dermatitis |
|
Definition
Diagnosis is made clinically
Serum IgE is frequently elevated |
|
|
Term
| Therapy for atopic dermitis |
|
Definition
| Topical steroids, systemic anti-histamines, wet dressings and baths may be helpful in acute stage; moisturizers reduce dry skin; in some children food allergy can cause atopic dermatitis |
|
|
Term
| Definition of seborrheic dermatitis |
|
Definition
| Waxing and wanning, superficial, inflammatory process; bilateral and symmetrical; affects scalp, eyebrows, nasolabial creases and intertriginous areas (axilla, groin, buttocks, inflammatory folds); infants and adults; assoc. with Parkinson's disease and AIDS |
|
|
Term
| Therapy of seborrheic dermatitis |
|
Definition
| Anti-seborrheic shampoos are mainstay of treatment of scalp involvement; topical steroid lotion for hair areas; cream for nonhairy skin |
|
|
