Skin Inflammation Treatments Quiz

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Questions and Answers

What is one advantage of using topical corticosteroids over oral steroids?

They require longer treatment times.

They have more side effects.

They have less side effects. (correct)

They can cause more stretch marks.

What is a common treatment option mentioned for skin conditions?

Surgical intervention

Phototherapy

Oral antibiotics

Topical steroids (correct)

Which of the following treatments can complete a skin condition treatment plan?

Intravenous solutions

Mild oral steroids

Systemic antifungals

Topical corticosteroids and Vitamin D analogues (correct)

What is a possible side effect of topical steroids?

Stretch marks Signup and view all the answers

Compared to topical corticosteroids, how do side effects of topical steroids generally compare?

They are less severe. Signup and view all the answers

What is a key aspect of the inflammatory pathways mentioned?

Suppression of specific mediators Signup and view all the answers

Which mediators are specifically indicated for suppression in the inflammatory pathways?

IL-17 and IL-27 Signup and view all the answers

What is the potential goal of suppressing IL-17 and IL-27 in inflammatory processes?

To modulate immune system balance Signup and view all the answers

What effect does IL-17 typically have in inflammatory pathways?

It enhances the immune response Signup and view all the answers

Which strategy might one utilize to control inflammation related to IL-27?

Targeting receptors that IL-27 binds to Signup and view all the answers

What does the term erythema refer to?

Redness of the skin Signup and view all the answers

Which areas of the body are generally affected by erythema?

Extensor surfaces and scalp Signup and view all the answers

What factors influence the occurrence of erythema?

Genetic and environmental influences Signup and view all the answers

Which description best characterizes the duration and variability of erythema?

Variable in duration, flares, and extent Signup and view all the answers

What is meant by extensor surfaces?

Skin surfaces on the outer aspect of a joint Signup and view all the answers

What is defined as the presence of nucleated cells in the stratum corneum?

Parakeratosis Signup and view all the answers

In which conditions is parakeratosis commonly observed?

Psoriasis and dermatitis Signup and view all the answers

Which layer of the skin is primarily affected by parakeratosis?

Stratum corneum Signup and view all the answers

What histological feature distinguishes parakeratosis from normal keratinization?

Retained nuclei in keratinized cells Signup and view all the answers

Parakeratosis is most commonly associated with which of the following skin disorders?

Psoriasis Signup and view all the answers

What is Koebner's phenomenon?

The presence of isomorphic lesions at the site of trauma. Signup and view all the answers

When does Koebner's phenomenon typically occur after an injury?

7–14 days after the injury. Signup and view all the answers

What does the Oil drop sign refer to in psoriasis?

Nail discoloration resembling an oil drop. Signup and view all the answers

What characterizes generalized pustular psoriasis?

Waves of pustules on erythematous skin Signup and view all the answers

What is the effect of scratching or burning an area of trauma in an individual with psoriasis?

It triggers new lesions of psoriasis. Signup and view all the answers

Which of the following is NOT a triggering factor for generalized pustular psoriasis?

Dietary changes Signup and view all the answers

Which area of the body is NOT typically associated with psoriasis symptoms such as Koebner's phenomenon?

Feet Signup and view all the answers

What is a characteristic of localized pustular psoriasis?

Sterile pustules without bacteria Signup and view all the answers

What age group is more commonly affected by palmoplantar pustular psoriasis?

Women in their fifth or sixth decade Signup and view all the answers

Which of the following correctly describes a macular patch?

A flat lesion with a color change Signup and view all the answers

Study Notes

Psoriasis Lecture Notes

Psoriasis is a chronic, disfiguring, inflammatory, and proliferative skin condition.
Skin lesions are red, scaly, and sharply demarcated plaques.
Psoriasis commonly affects extensor surfaces and scalp.
Genetic and environmental factors influence its development.
Skin lesions vary in duration, with periods of flares and remissions.
It affects 2% of the global population.
Caucasians are most affected.
Males and females are equally affected.

Pathogenesis

Psoriasis is a T-cell-mediated inflammatory disease.
Keratinocytes (skin cells) hyperproliferate (grow rapidly).
Keratinocyte maturation is impaired.
Inflammation and vascular changes occur.
Genetic factors play a role, with HLA-Cw6 being a notable genetic marker.
Skin cells regenerate every 4 days compared to 28 days in healthy people.

Clinical Features

Psoriasis lesions are typically round or oval, well-defined, and erythematous (reddened) with plaques.
Lesions are often symmetrical.
Covered with white, silvery scales.
Commonly found on extensor extremities (elbows, knees, buttocks, and scalp).

Distribution of Lesions

Psoriasis lesions can appear on various parts of the body, including the scalp, elbows, knees, and the area around the navel (umbilicus).
They can also appear on the ears, and nails.

Associated Diseases

Arthritis
Enteropathy (intestinal disease)
Myopathy (muscle disease)
Heart disease
Spondylitis(spinal joint inflammation)

Histopathology

Thickening of the epidermis.
Retention of nuclei in keratinocytes (keratin-producing skin cells) in the stratum corneum (outermost skin layer). This causes silvery scales.
Munro microabscesses in the stratum corneum.
Spongiform pustules in the Malpighian layer (a deeper skin layer).
Tortuous (winding) and dilated blood vessels are present in the dermis.

Clinical Types

Chronic stable plaque psoriasis (psoriasis vulgaris)
- Salmon-pink, scaly plaques.
- Common on extensor extremities (elbows, knees, etc).
- Koebner's phenomenon (isomorphic response to trauma). Lesions develop to the site of trauma.
- Oil drop sign (appears on nails).
- Auspitz's sign (pinpoint bleeding after scraping lesions).
Guttate psoriasis:
- Small, 0.5-1.5 cm papules and plaques.
- Early onset, often in children, after a streptococcal throat infection.
- Spontaneous remission is possible.
Erythrodermic psoriasis:
- Classic lesions are lost.
- Entire skin becomes erythematous (red) and scaly.
- Febrile (accompanied by fever).
- Severe, generalized condition impacting the entire skin.

Triggering Factors for Erythrodermic Psoriasis

Systemic infections.
High-potency topical or oral steroid withdrawals.
Methotrexate withdrawal.
Phototoxicity (sun sensitivity).
Irritant contact dermatitis.
Medications.

Generalized pustular psoriasis

Gradual or acute onset.
Pustules form on erythematous skin surfaces.
Associated with weight loss, hypocalcemia (low blood calcium), muscle weakness, leukocytosis (high white blood cell count), elevated ESR (erythrocyte sedimentation rate).
Fever may be present.

Generalized pustular psoriasis triggering factors:

Infections.
Stress.
Pregnancy.
Lithium.
Hypocalcemia.
Irritant contact dermatitis.
Corticosteroid withdrawal.

Localized Pustular Psoriasis (Palmoplantar)

Common in women, typically in their 50s and 60s.
Characterized by deep-seated pustules.
Palmoplantar areas (palms and soles) are commonly affected.
May mimic hand-foot eczema.
Often aggravated by trauma.

Palmoplantar, nail, and scalp involvement

Palmoplantar:
Typical scaly patches, with silvery scales.
Absence of vesiculation (small blisters).
Knuckles often show thickening.
Nail Involvement:
25%-50% of patients.
Fingernails more often affected than toenails.
Onycholysis (separation of nails from nail bed).
Nail pitting.
Subungual hyperkeratosis (thickening under the nail).
"Oil drop sign"
Scalp:
Very thick plaques develop.
Dry, silvery scales.
Often extends beyond the hairline.

Treatment

Mild: Topical corticosteroids, Vitamin D analogs.
Moderate: Topical corticosteroids + phototherapy, vitamin D analogs.
Severe: Topical medications + systemic agents (methotrexate, retinoids, cyclosporine), biologics.

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Description

Test your knowledge on the treatments for skin inflammatory conditions, particularly the differences between topical corticosteroids and oral steroids. This quiz covers mechanisms, common treatments, and key inflammatory mediators involved in skin care. Dive into the specifics of erythema and its influencing factors.