Dermatology 3

May 23rd

What is the treatment of pubic lice?

• Permetrhrin 1% cream or lotion

• Benzyl benzoate (25% in oily solution)

• Shaving

List at least 3 cutaneous diseases associated with type II hypersensitivity reactions

1) Pemphigus Vulgaris

2) Bullous Pemphigoid

3) Dermatitis Herpetiformis of Duhring

Clinical Case: A 58‐year‐old male with a history of mild hypertension and recently unexplained weight loss of 10 pounds over 2 months presents to the dermatology clinic with severe, painful oral erosions that have progressively worsened over the past month. The patient initially noticed persistent soreness and ulcerations on his buccal mucosa and tongue, which made eating and speaking difficult. Soon after, he developed polymorphous skin lesions that varied in appearance—ranging from flaccid bullae to erosive patches and papules with a lichenoid quality—distributed over his trunk, axillae, and extremities. Nikolsky sign is positive. He also recently has had trouble breathing. What is the most likely diagnosis?

PARANEOPLASTIC PEMPHIGUS

What kind of treatments can be used for scarring management?

1. Peels

2. Microneedling

3. Laser therapy

4. Laser therspy + lipofiller

5. Punch excision

What are some of the pathologies that go in differential diagnosis with Erythematotelangiectatic Rosacea?

1. SLE

2. Acne Vulgaris

3. Contact dermatitis

4. Seborrheic dermatitis

5. Carcinoid syndrome

6. Photodermatitis

Define onycholysis and list 3 causes

Onycholysis is the separation of the nail bed from the nail plate.

1. Psoriasis

2. Repetitive trauma

3. Onychomycosis

What is the difference between true and apparent leukonychia?

In apparent leukonychia the whitish discoloration of the nail does not move with nail growth towards the free edge of the nail, while in true leukonychia it does.

Describe the timing of patch test and the crescendo reaction

The patch test is put on the patient at time zero. After 48h, it is taken off the patient and a first reading is done. If there are doubts, a second reading is done after 72h.

The crescendo reaction is the progressively intensifying skin reaction at the site of the test over time.

Which is the target of Dupilumab?

Dupilumab is a monoclonal antibody that targets the alpha subunit of IL-4 and IL-13 receptors.

Which are the criteria for the diagnosis of atopic dermatitis?

The criteria of atopic dermatitis are those proposed by Hanifin and Rajka in 1980 and include major and minor criteria. A diagnosis of atopic dermatitis is made when 3 or more of the four major criteria and 3 or more of the minor criteria are met.

The major criteria (4) are:

1. Pruritus,

2. Typical morphology and distribution

3. Chronic or chronically relapsing dermatitis

4. Personal/family history of atopy.

The minor criteria:

1. Xerosis,

2. Ichthyosis,

3. Keratosis pilaris,

4. Palmar hyperlinearity,

5. Positive skin prick test,

6. Elevated serum IgE,

7. Early age of onset,

8. Increased risk of infection,

9. Risk of non-specific hand or foot dermatitis,

10. Nipple eczema,

11. Cheilitis,————

12. Recurrent conjunctivitis,

13. Dennle-Morgan infraorbital folds,

14. Orbital darkening

15. Facial pallor or erythema,

16. Pityriasis alba,

17. Wool intolerance,

18. Food intolerance,

19. Exacerbation by environmental or emotional stress,

20. White dermographism,

21. Anterior neck folds,

22. Increased risk to develop cataracts.