Upgrade to remove ads
Only $2.99/month

dermatitis and psoriasis

Terms in this set (47)

atopic dermatitis
aka eczema or the itch that rashes
inflammatory papulosquamous process of the skin
acute or chronic
what can atopic dermatitis present as
erythema
papules
vesicles
pustules
scales
crusting
serious oozing
any combo of wet or dry
atopic dermatitis etiology
unknown
common associated with igE elevations
epidermal barrier disruption
genetic predilection
atopic triad
atopic dermatitis, allergic rhinitis, asthma
atopic dermatitis epidemiology
10% of children
1% of adults
95% cases in kids under 5
atopic dermatitis clinical manifestation
pink/red scaly papules/plaques/patches
ill defined borders
intense itching/pruritus
xerosis/dryness
hyperlinear palms
post auricular fissures
dennie morgan folds
lichenification
most common locations for atopic dermatitis
face (especially cheeks), antecubital fossae, popliteal fossae
all flexural areas
xerosis
dry skin
white appearance with scales
dennie morgan folds
redness associated
lines from inflammation from rubbing/itching
lichenification
thicker/callused skin from itching
red/pink or hyperpigmented skin
atopic dermatitis and topical steroids
range of strengths with classes 1-7
class 1 is strongest and 7 is the weakest
caution on thin skinned areas like eyelids and genitalia because risk of atrophy
atopic dermatitis and antibiotics
if bacterial inf. suspected
cephalexin or dicloxacillin if staph aureus
bactrim or doxycillin if MRSA
atopic dermatitis and moisturizers
use thick cream or ointment
aquaphor, eucerin, cetaphil, ceraVe, aveeno
main prevention
things to avoid with atopic dermatitis
frequent bathing
hot water
harsh fabrics
fragrances
all make skin dryer
atopic dermatitis and systemic corticosteroids
may be used in decreasing dose for acute flares
atopic dermatitis and immune modulators
tacrolimus (protopic)
pimecrolumus (elidel)
help maintain healthy skin states
not as good for acute flares
safer on skin, like eyelids
atopic dermatitis and antihistamines
benadryl
zyrtec (longest lasting)
hydroxyzine
help with itching
atopic dermatitis treatment in severe cases
oral immunomodulators that suppress immune system
ultraviolet B light
allergy testing
two types of contact dermatitis
allergic or irritant
allergic contact dermatitis
antigen penetrates skin and sets up an allergic response
no s/sxs on first exposure
allergic contact dermatitis common allergens
plants: urushiol (poison ivy or oak; linear vesicles)
jewelry: nickel
clothing
topical medications: preservatives
cosmetics (nail polish)
irritant contact dermatitis
atopic dermatitis in response to chronic exposure to substance
irritant contact dermatitis common causes
saliva
citrus juices
soaps bc drying
diapers
hand washing
contact dermatitis treatment
avoid causative agent
low dose of topical corticosteroid for mild cases
antihistamines
oral corticosteroids (3 wk taper) if moderate to severe
you should never treat atopic or contact dermatitis with what?
medrol dose pack
factors that decrease risk of atopic dermatitis
pet exposure
3/more siblings
day care
farm residence
hand/dyshidrotic dermatitis
itchy micro vesicles
avoid ointments because plug pores
atopic vs. exposure
irritant vs. allergic
nummular eczema
round coinlike lesions
papular or crusty/scaly patches
psoriasis etiology
immunologically medicated disease due to increased T cell activity in skin
genetic predilection
stress
cold weather
trauma
infection
psoriasis epidemiology
1-3% of world population affected
median age of onset is 28
50% have family history if it
10-30% develop psoriatic arthritis
psoriasis presentation
erythematous base
well demarcated border
silvery scale
auspitz sign
plaque psoriasis
most common
found on outer elbows, top of knees, gluteal cleft, extremities, and scalp
inverse psoriasis
affects body folds (intertriginous)
no scale or only minor amount
often misdiagnosed as yeast inf.
gluttate or eruptive psoriasis
more common in children/young adults
often erupts 2-3 weeks after strep inf.
appears as multiple small scaly plaques on trunk and limbs
pustular psoriasis
most severe; can be life threatening
may be diffuse or only on palms/soles
sterile pustules that dry and peel
do NOT give oral steroids
pustular psoriasis risk factors
withdrawal of systemic corticosteroids
meds
skin infections
sun or tanning beds
topical irritants
hand/foot psoriasis
minor to severe scaling, fissures, and/or pustules on palms and soles
very challenging to control, can be debilitating
nail psoriasis
presents as pitting, color changes, thickening, and easily eroding
cosmetically challenging
medications to avoid with psoriasis
beta blockers
lithium
antimalarials
NSAIDS
ACE inhibitors
terbinafine
psoriasis treatment with topical corticosteroids
cautious use on face, neck, genitals, and intertriginous areas (thin skin)
ointment, cream, or solutions
consider occlusive dressings on stubborn plaques
psoriasis additional treatment
coal tar ointments, emulsions, and shampoos
ultraviolet B light
topical vitamin D preparation (calcipotriene)
retinoids
biologics
immunosuppressives
psoriasis treatment with retinoids
vitamin A derivatives used more frequently in acne
helps to thin psoriatic plaques
psoriasis treatment with biologics
injections or infusions targeting certain immune cells that result in inflammation and plaque formation
psoriasis treatment with immunosuppressives
for severe cases
either cyclosporine or methotrexate
cyclosporine
careful monitoring required
long term risk of renal toxicity which may not be detected by blood tests
limit long term use
methotrexate
can interfere with folic acid absorption
high risk of liver toxicity
avoid if liver disease or alcoholism
you should not treat psoriasis with
oral steroids
THIS SET IS OFTEN IN FOLDERS WITH...