8/13/2019 Kukel Werd

1/3

Physic exam :Physic exam :-- shaplyshaply marginatedmarginated erythematouserythematous papulespapules--plaquesplaques

with transparent silverywith transparent silvery--white scales. Scalewhite scales. Scaleareare lamellerlameller, loose, loose scratchingscratching easy removeeasy remove

minute blood droplets (minute blood droplets (AuspitAuspit sign!sign!

acuteacute guttataeguttatae type :type :

-- salmonsalmon--pin" papules (pin" papules (guttagutta, drop! with transparent, drop! with transparent

scalescale-- trun"trun"

-- resolve spontaneouslyresolve spontaneously #ew wee"s#ew wee"s recurrentrecurrent

chronic stable type : sharplychronic stable type : sharply marginatedmarginated,, dullreddullred plaques,plaques,

lamellar silverylamellar silvery--white scaleswhite scales

palms and soles : massive silverypalms and soles : massive silvery--white $ yellowishwhite $ yellowishhyper"eratosis %hyper"eratosis % scallingscalling, is not easily remove, is not easily remove

pain#ul #issurespain#ul #issures

scalp : plaques, sharplyscalp : plaques, sharply marginatedmarginated thickthick

adherent scaleadherent scale

nail : pitting,nail : pitting, subungualsubungual hyperkeratosis,hyperkeratosis,

onycholysisonycholysis, yellowish, yellowish--brown spots under nail plabrown spots under nail pla

spot)spot) pathognomonispathognomonis

Lab:Lab: -- serology :serology : antistreptolysin titerantistreptolysin titeruricuric scidscid goutygouty

arthritisarthritis

-- histopathohistopatho :: acanthosisacanthosis,, mitosismitosis

keratinocyteskeratinocytes,, parakeratoticparakeratotic

hyperkeratosis,hyperkeratosis, microabscessesmicroabscesses ofofMunroMunro

DD :DD : eborheiceborheic Dermatitis, Lichen simple!Dermatitis, Lichen simple! chronicuchronicu "ityriasis"ityriasis #osea#osea, $%, $% &orporis&orporis

8/13/2019 Kukel Werd

2/3

P&S'&(A) PS*)+AS+SP&S'&(A) PS*)+AS+S

Def :characteri'ed by pustules arising onDef :characteri'ed by pustules arising on

normal(inflamed,normal(inflamed, erythematouserythematous skin%skin%

) types :) types : generili'edgenerili'ed ** palmopalmo--plantarplantar

"almo"almo--plantar :plantar :

Def :Def : -- chronic, relapsing eruption limited to the palmschronic, relapsing eruption limited to the palms

*soles%*soles%

-- sterilsteril,, yelowyelow, deep, deep--seated pustulesseated pustules duskydusky--redredcrustscrusts

--ympymp :tingling, burning:tingling, burning ichingiching

-- kinkin lessionslessions : pustules ): pustules )--+ mm, deep+ mm, deep--seated, duskyseated, dusky--

redred maculesmacules crusts incrusts in erythemaerythema, scaling, scaling

or normal skinor normal skin

-- DD : $ Manus,DD : $ Manus, DyshidroticDyshidrotic ec'ematous Dermatitis,ec'ematous Dermatitis,

.nf.nf

DEF

S*)+/ 0)1A'+'+S

//0e# :very common chronic dermatitis characteried by redness0e# :very common chronic dermatitis characteried by redness

% scaling% scaling sebaceous gland moresebaceous gland more active:#aceactive:#ace,, scalp,bodyscalp,body

#old,#old, presternalpresternal areaarea

//pidpid :: -- age o# onset : in#ancy (#irst month!age o# onset : in#ancy (#irst month!

puberty,mostpuberty,most2323--43y43y

-- sex : 156sex : 156

-- incidence : 2incidence : 2--47 pop47 pop

//Predisposing % exacerbating #actor :Predisposing % exacerbating #actor :

-- immunocompetentimmunocompetent

-- emotional stressemotional stress

//PahogenesisPahogenesis : 8: 8 1alasseia1alasseia #ur#ur#ur#ur play a roleplay a role

//Physical exam :Physical exam :

orangeorange--red or grayred or gray--white s"in o#ten withwhite s"in o#ten with 99greasygreasy oror

white dry scalingwhite dry scaling maculesmacules % papules (4% papules (4--23mm!23mm! stic"y cstic"y c

rusts % #issures (#old behind the external ear!, scalprusts % #issures (#old behind the external ear!, scalp

mar"ed scaling (dandru##!mar"ed scaling (dandru##!

//'x'x : topical :: topical :glucocorticoidglucocorticoid,, "eto"onaol"eto"onaol 27, tar,27, tar, tacrolimustacrolimus

&; radiation&; radiation

systsyst :

8/13/2019 Kukel Werd

3/3

Def : the term for all clinical feature thatcharacterized by generalized anduniform redness and scaling involvingpractically the entire skin.

Pathogenesis :

he most fre! :

" dermatitis

" psoriasis

" lymfoma # leucemia

" adverse cutaneous drug eruption

,)>')*0,)1A

Physical e$am :

% Dermatitis # lymfoma&leucemia acute erythema patch

'()"*+ herythroderma

,fever- shivers- hot # cold.

')"/ d

de!uamation

'0

hair loss ,scalp # body.

onycolysis-thicken nail

%1istory most important

2anagement :

" opical : 0ater bath 3 bath oil blandemollients

" 4ral : " glucocorticoid remission

%$ syst # topical underlying condition