PLE Common, photosensitivity eruption Adult females 20- 40 yrs, 10% women holidaying in the med!...
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PLE Common, photosensitivity eruption Adult females 20- 40 yrs, 10% women holidaying in the med! Rash takes many forms but tends to be the same for an individual crops of 2-5 mm pink or red raised spots occurring on the arms. Also chest and lower legs, but the face is usually spared. Burning/itch May be blistered/dry or e.multiforme like May be confined to ears
PLE Common, photosensitivity eruption Adult females 20- 40 yrs, 10% women holidaying in the med! Rash takes many forms but tends to be the same for an
PLE Common, photosensitivity eruption Adult females 20- 40 yrs,
10% women holidaying in the med! Rash takes many forms but tends to
be the same for an individual crops of 2-5 mm pink or red raised
spots occurring on the arms. Also chest and lower legs, but the
face is usually spared. Burning/itch May be blistered/dry or
e.multiforme like May be confined to ears
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Settles with sun avoidance, but recurs Can deteriorate if not
allowed to settle extensive hardening as the summer progresses and
more sun can be tolerated some very sensitive individuals even
develop PMLE in the winter immune reaction to a compound in the
skin which is altered by exposure to ultraviolet radiation short
wavelength UVB but also longer wavelength UVA Occurs through glass,
sunblockers may be ineffective
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Prevention Cover all affected areas Choose UPF 40+ clothing
Broad Spectrum Sun Protection Factor 30+ semi-opaque sunscreen Stay
in the shade Treatment Short course of oral steroids e.g. to cover
a summer holiday. Polypodium leucotomos extract (PLE)(Heliocare)
Beta carotene. Hydroxychloroquine UVA or PUVA
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PLE
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Juvenile Spring Eruption
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Localised from of PLE Sun induced, exposed areas esp skin of
ears Occurs 8-24 hrs after exposure lasting some 2 wks Affects
young males in spring (!) Itchy red lumps forming blisters and
crusts Resolves after several weeks Steroids/emollients
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Solar elastosis
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Melasma
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Blotchy pigmentation due to overproduction of melanin Pregnancy
will resolve with time Drugs OCP Sun Sun blockers Stop offending
drugs Azalaic acid may prevent new pigment Salicylic acid creams
Await resolution
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Erosive Pustular Dermatosis Rare disorder, but do see it!
Unknown aetiology Clinical diagnosis Sterile crusting erosions and
pustules Seen in atrophic skin sec to actinic or other damage incl
cryotherapy Yellow/brown crusts, erosions, pustules, purulent
leakage and lakes of pus. Oedema, erythema, lymphadenopathy
absent
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Erosive Pustular Dermatosis
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Treatment Remove crust with oil Treat with potent/ultrapotent
topical steroid ie dermovate Review at 3 wks Investigations -
nil
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What lesions are demonstrated? What is the condition? Quizz:
Max 20 Closed comedones Acne
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1 what lesions are demonstrated? 2 name the condition Pustules
Acne
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1 what lesion is demonstrated? 2 can it occur alone? Open
comedone Yes Giant/senile comedone
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1 - Would you refer this patient? 2 - What treatment would be
considered? Yes Roaccutane
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1 What is the diagnosis? 2 What are the two diagnostic clues?
Perioral dermatitis Perioral Vermillion area spared
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1 Give three diagnostic features 2 and the diagnosis Nasolabial
sparing Erythema Telangiectasiae Pustules Papules Rosacea
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1 Give a name to the complication affecting his nose? 2 Name
two ocular manifestations Rhinophyma Blepharitis Keratitis
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1 - Diagnosis please? 2 What microorganism is implicated?
Seborrhoeic eczema Pityrosporum ovale
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1 List two classical features of this process 2 Give the
diagnosis Scarring Alopecia CDLE
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1 Name the process? 2 Give two precipitants? Melasma Pregnancy
Drugs
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Diagnosis? Lick eczema
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?Delayed hypersensitivity reaction to oil ?PLE acquired during
a recent beach holiday in Libya Or a bad case of photoshop!
http://youtu.be/JlmEc8rd_Nw
Impetigo superficial skin infection of the epidermis
characterized by translucent (honey) crusts caused by S. aureus and
strep. pyogenes (GABHS) Flucloxacillin Bactroban topical
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Impetigo Two variations of impetigo Bullous impetigo is more
often caused by S. aureus Ecthyma has a ulcerated punched-out
base
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Ecythma Ecthyma begins as a vesicle or pustule overlying an
inflamed area of skin that deepens into a dermal ulceration with
overlying crust. The crust of ecthyma lesions is gray-yellow and is
thicker and harder than the crust of impetigo. A shallow,
punched-out ulceration is apparent when adherent crust is removed.
The deep dermal ulcer has a raised and indurated surrounding
margin. Ecthyma lesions can remain fixed in size (sometimes
resolving without treatment) or can progressively enlarge to 0.5-3
cm in diameter. Ecthyma heals slowly and commonly produces a scar.
Regional lymphadenopathy is common, even with solitary lesions
