other types: - ps. vulgaris - pustular ps - eryhtrodermic (>80% of body) - arthropathic tyoe - linear/zosteriform - palmoplantar ps. - flexular ps. - circinate ps. - guttate ps.
*Auspitz sign = on removal of scales bleeding point
3 topical Rx: - emollient (Vaseline) - keratolytic (salicylic acid) - Vit D analogue - steroid in localized case - PUVA *topical steroid may cause relapse + pustular psoriasis
TINEA CORPORIS (CIRCINATA) EROSIVE INTERDIGITALIS ONYCHOMYCOSIS PITYRIASIS VERSICOLOR well defined circinate patch - scaly patch - healing centre - active margin
other types: - t. facii - t. pedia & manuum - t. corporis - t. circinata
T. Pedis subtypes: - vesiculo- bullous/eczematous - hyperkeratotic - toe web maceration (athletic foot) - circinate type
VERRUCA PLANA - HPV -minute, multiple flat topped papule w smooth surface - skin coloured - on the face & back of hands *may show Koebners phenomenon
Rx : topical retinoid
cause: Human Papilloma Virus (HPV)
malignant transformation - in HPV type 16, 18, 45, 31
C. Acuminata C. Lata HPV 6, 11, 16,18,91 (venereal verruca) Treponema Pallidum (2ry stage syphilis) - cauliflower - pedunculated - foul odour - easily bleeds on touch - sessile - flat topped - doesnt bleeds on touching Rx by podophyllin Rx by penicillin
Rx = destruction of the warts i) chemical cautery : podophyllin 25% *teratogenic ii) laser cautery iii) electrocautery iv) cryotherapy *of choice in pregnancy dome-shpaed pearly white papule + central umbilication
in children
etio: molluscum pox virus
Rx: needle transfixation + curettage
DDx of umbilicated skin lesion: - -
DDx of other lesion showing Koebners phenomenon: - - - - -
VERRUCA VULGARIS VERRUCA PLANTARIS - dome shaped
other types:
Rx:
etio:
line of Rx:
other types:
VITILIGO ALOPECIA AREATA ATOPIC DERMATITIS URTICARIA milky white depigmented macule/patch
- in any site ( at the site of trauma)
pathogenesis i. autocytotoxic theory (by toxic by-product produced during melanin production) ii. auto-immune destruction iii. intrinsic defect of structure & function iv. neural v. defective free radical defense
clinical types: 1. localized i) segmental (dermatomal) ii) focal iii) mucosal *bad prognosis (no hair follicle) 2. generalized (>60%) - vulgaris - acrofacial 3. universal localized area of hair loss devoid of hair stumps & scales (normal scalp)
bad prognostic sign: - +ve family Hx - ass w/ nail dystrophy & autoimmune disease - subcapsular cataract - ophiasis type - subtotalis/universalis - early onset *exclamation mark!
2 topical Rx 1. steroid 2. irritant althralin
DDx of non-cicatricial alopecia *if beard & adult NO tinea capitis!
*ANDROGENIC ALOPECIA minoxidil 2% in females 5% in males
Major criteria: - chronic relapsing course -pruritis - +ve family hx of atopy - typical distribution