Derm-4

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Author:
atmu
ID:
174633
Filename:
Derm-4
Updated:
2012-10-01 02:39:08
Tags:
Derm
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Description:
Derm-4
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  1. 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
  2. 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
  3. 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)
  4. 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)
  5. 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
  6. 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
  7. Atopic Dermatitis
    -Definition
    -Types
    -Triad
    • -Definition: chronic relapsing dermatitis assocated w/ pruritis
    • -Types: acute, subacute, chronic
    • -Triad: asthma, hay fever, eczema
  8. 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
  9. 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
  10. Seborrheic Dermatitis
    -Sx
    • chronic inflammatory dermatits; worse in pts w/ neurological conditions; "dandruff"
    • -Sx: yellow "greasy" scale, yellow-red macules
  11. 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
  12. 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
  13. 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

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