1 / 51

PLE

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

fala
Télécharger la présentation

PLE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 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

  2. 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

  3. 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. • Polypodiumleucotomos extract (PLE)(Heliocare™) • Beta carotene. • Hydroxychloroquine • UVA or PUVA

  4. PLE

  5. Juvenile Spring Eruption Juvenile Spring Eruption

  6. 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

  7. Solar elastosis

  8. Melasma

  9. 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

  10. Erosive PustularDermatosis • 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

  11. Erosive Pustular Dermatosis

  12. Treatment • Remove crust with oil • Treat with potent/ultrapotent topical steroid ie dermovate • Review at 3 wks Investigations - nil

  13. Quizz: Max 20 What lesions are demonstrated? What is the condition? Closed comedones Acne

  14. 1 – what lesions are demonstrated? 2 – name the condition Pustules Acne

  15. 1 – what lesion is demonstrated? 2 – can it occur alone? Open comedone Yes Giant/senile comedone

  16. 1 - Would you refer this patient? 2 - What treatment would be considered? Yes Roaccutane

  17. 1 – What is the diagnosis? 2 – What are the two diagnostic clues? Perioral dermatitis Perioral  Vermillion area spared

  18. Nasolabial sparing Erythema Telangiectasiae Pustules Papules Rosacea 1 – Give three diagnostic features 2 – and the diagnosis

  19. 1 – Give a name to the complication affecting his nose? 2 – Name two ocular manifestations Rhinophyma Blepharitis Keratitis

  20. Seborrhoeic eczema Pityrosporum ovale 1 - Diagnosis please? 2 – What microorganism is implicated?

  21. Scarring Alopecia CDLE 1 – List two classical features of this process 2 – Give the diagnosis

  22. 1 – Name the process? 2 – Give two precipitants? Melasma Pregnancy Drugs

  23. Diagnosis? Lick eczema

  24. ?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

  25. Thankyou!

  26. paracetamoxyfrusbendroneomycin

  27. Bacterial infections of skin • Impetigo, cellulitis/erysipelas • Folliculitis • Furuncle, carbuncle, abscess • Cutaneous Leishmaniasis • Leprosy • TB (Lupus vulgaris) • Anthrax

  28. Cellulitis

  29. Staphylococcal Folliculitis

  30. Erysipelas

  31. P

  32. Impetigo • superficial skin infection of the epidermis • characterized by translucent (“honey”) crusts • caused by S. aureus and strep. pyogenes (GABHS) • Flucloxacillin • Bactroban topical

  33. Impetigo • Two variations of impetigo • Bullous impetigo is more often caused by S. aureus • Ecthyma has a ulcerated “punched-out” base

  34. 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

  35. CutaneousLeishmaniasis

  36. TB (Lupus vulgaris)

  37. Viral • HSV1 • Herpes • Varicella/Zoster • Molluscum contagiosum • Exanthems

More Related