Dermatology 3

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Questions and Answers

What is the primary mechanism of action shared by emollients, topical steroids, and systemic treatments like methotrexate in managing psoriasis?

  • Increasing the rate of skin cell differentiation.
  • Blocking the inflammatory response mediated by IgE.
  • Enhancing the skin's natural moisturizing factor (NMF) production.
  • Reducing the rate of skin production. (correct)

A dermatologist observes flat-topped, violaceous papules on a patient's wrists and lower back. Which skin condition is MOST likely indicated by these observations?

  • Rosacea.
  • Eczema.
  • Psoriasis vulgaris.
  • Lichen planus. (correct)

Which variant of lichen planus is characterized by thick, raised plaques that are often more persistent and difficult to treat compared to other forms?

  • Macular lichen planus.
  • Papular lichen planus.
  • Hypertrophic lichen planus. (correct)
  • Atrophic lichen planus.

A patient with lichen planus is concerned about potential long-term effects on their skin and nails. Which areas are MOST prone to scarring as a result of this condition?

<p>Scalp and fingernails. (C)</p> Signup and view all the answers

During an oral examination, a dentist notices a lacy, white network on the buccal mucosa along with bright red gums. Which feature is MOST indicative of oral lichen planus?

<p>Reticular pattern. (C)</p> Signup and view all the answers

What is a common first-line topical treatment for managing the inflammation and discomfort associated with lichen planus?

<p>Topical steroids. (D)</p> Signup and view all the answers

In cases of severe or widespread lichen planus, which systemic treatment is often considered to suppress the immune system and reduce inflammation?

<p>Prednisolone (B)</p> Signup and view all the answers

A child presents with a rash characterized by vesicles appearing in successive crops, giving the appearance of lesions in various stages of development. What condition is MOST likely responsible for this presentation?

<p>Chickenpox. (C)</p> Signup and view all the answers

An elderly patient develops a painful, unilateral vesicular rash along a single dermatome. Which condition is MOST likely the cause, and what underlying factor contributes to its development?

<p>Shingles, due to reactivation of latent varicella-zoster virus. (D)</p> Signup and view all the answers

A patient presents with recurrent vesicular lesions around the mouth and on the fingers. What is the MOST likely viral cause of these infections?

<p>Herpes simplex virus. (B)</p> Signup and view all the answers

A child has several small, shiny papules with a central indentation (umbilication) on their trunk. Which viral infection is MOST likely responsible for these skin lesions?

<p>Molluscum contagiosum. (D)</p> Signup and view all the answers

A patient presents with common warts on their hands. Which virus is the MOST likely cause of these lesions?

<p>Human papillomavirus. (B)</p> Signup and view all the answers

A child is diagnosed with impetigo. What is the MOST likely bacterial cause of this skin infection?

<p><em>Staphylococcus aureus</em>. (B)</p> Signup and view all the answers

An adult patient develops a localized, warm, and tender area of skin on their lower leg, diagnosed as cellulitis. What is the typical treatment approach for this condition?

<p>Intravenous antibiotics. (A)</p> Signup and view all the answers

A patient presents with paronychia, an infection around the nail. What is the MOST likely bacterial cause of this condition?

<p><em>Staphylococcus aureus</em>. (B)</p> Signup and view all the answers

A patient is diagnosed with a fungal infection of the skin. Which fungal species is MOST commonly responsible for these types of infections?

<p><em>Trichophyton species</em>. (C)</p> Signup and view all the answers

A patient is prescribed calcipotriol for their psoriasis. What is the mechanism of action of this medication?

<p>It reduces the rate of skin production. (A)</p> Signup and view all the answers

Which of the following is a characteristic feature that distinguishes shingles from chickenpox?

<p>Unilateral distribution of the rash. (B)</p> Signup and view all the answers

A patient presents with bright red gums and a white lacy pattern on the inside of their cheeks. Which condition is MOST likely?

<p>Reticular lichen planus. (D)</p> Signup and view all the answers

Which of the following medications used to treat psoriasis is classified as a systemic treatment?

<p>Methotrexate. (C)</p> Signup and view all the answers

Flashcards

Psoriasis treatments

Emollients/bath oils, Vitamin D analogues, Tar preparations, Topical steroids, Dithranol, UVB/PUVA, Systemic treatments (acitretin, methotrexate, cyclosporin, biologics). They all reduce the rate of skin production.

Lichen Planus appearance

Flat-topped, violaceous papules often found on flexor surfaces (wrists) and the lower back.

Types of Lichen Planus

Papular, Hypertrophic, and Macular/Pigmented.

Lichen Planus scarring

The scalp and fingernails.

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Oral Lichen Planus features

Reticular LP (a network of white lines) and Desquamative gingivitis (bright red gums).

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Topical Lichen Planus treatments

Emollients and topical steroids.

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Systemic Lichen Planus treatments

Prednisolone (a steroid) and Azathioprine/Mycophenolate/Methotrexate (immunosuppressant agents).

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Chicken Pox features

Rash appears in waves (polymorphic) and vesicles are present.

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Shingles features

Caused by dormant varicella virus, affecting one side of the body (unilateral).

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Herpes Simplex locations

Orally, on fingers, or in the genital area.

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Molluscum Contagiosum features

Shiny papules with umbilication (central indentation of the lesion).

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Human Papilloma Virus example

Warts.

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Staphylococcus Aureus infections

Impetigo, Cellulitis, and Paronychia. Treated with intravenous antibiotics.

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Cause of fungal infections

Trichophyton species.

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Study Notes

Psoriasis Treatments

  • Seven treatments for psoriasis include emollients/bath oils, Vitamin D analogues (e.g., calcipotriol), tar preparations, topical steroids, dithranol, UVB/PUVA, and systemic treatments like acitretin, methotrexate, cyclosporin, and biologics.
  • All treatments aim to reduce the rate of skin production.

Lichen Planus

  • Lichen planus appears as flat-topped violaceous papules on the skin.
  • It often affects flexor surfaces like wrists and the lower back.

Types of Lichen Planus

  • Papular lichen planus presents with small, raised bumps.
  • Hypertrophic lichen planus is characterized by thick, raised plaques.
  • Macular and pigmented lichen planus involves flat, discolored spots.

Lichen Planus Scarring

  • Lichen planus can cause scarring on the scalp and fingernails.

Oral Lichen Planus

  • Reticular lichen planus appears as a network of white lines.
  • Desquamative gingivitis, another form, presents as bright red gums.

Topical Treatments for Lichen Planus

  • Emollients and topical steroids can be applied topically.

Systemic Treatments for Lichen Planus

  • Systemic treatments include the steroid prednisolone.
  • Immunosuppressant agents like azathioprine, mycophenolate, and methotrexate are also options.

Chicken Pox

  • Chickenpox rashes occur in waves, displaying various stages simultaneously (polymorphic).
  • Vesicles are a characteristic feature.

Shingles

  • Shingles occurs when the varicella-zoster virus, which causes chickenpox, reactivates later in life.
  • Shingles is typically unilateral, affecting only one side of the body.

Herpes Simplex

  • Herpes simplex can manifest orally, on fingers, or in the genital area.

Pox Virus: Molluscum Contagiosum

  • Molluscum contagiosum is a pox virus that presents as shiny papules with a central indentation (umbilication).

Human Papilloma Virus: Warts

  • Warts are caused by the human papilloma virus.

Staphylococcus Aureus Infections

  • Impetigo, cellulitis, and paronychia can be caused by Staphylococcus aureus.
  • Intravenous antibiotics are the mode of treatment.

Fungal Infections

  • Fungal infections are commonly caused by Trichophyton species.

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