25 - Irritant Dermatitis

Question 1

Y/N: Irritant contact dermatitis predispose patients to developing atopic and allergic contact dermatitis.

Answer 1

Yes

Question 2

Irritant chemicals by definition do not cause scarring when in contact with the skin for less than

Answer 2

4 hours

Question 3

Y/N: When acute, irritant and allergic contact dermatitis cannot be reliably differentiated clinically or histologically.

Answer 3

No - When chronic

Patient history is very helpful when distinguishing acute irritant dermatitis from acute allergic contact dermatitis.

Question 4

(Women/Men) are more likely to have hand dermatitis

Answer 4

Women

Question 5

ACD/ICD: Sharp, strictly confined to the site of exposure

Answer 5

ICD

Question 6

ACD/ICD: Evolves 12-72 hours after exposure

Answer 6

ACD

Question 7

Most important irritant that provokes irritant dermatitis

Answer 7

Water

Question 8

Y/N: Oil dermatitis is characterized by perifollicular papules and pustules.

Answer 8

Yes

Question 9

ACD/ICD: Epidermal disruption is the primary finding.

Answer 9

ICD

Question 10

ACD/ICD: Displays proportionately more dermal inflammatory infiltrate.

Answer 10

ACD

Question 11

ACD/ICD: Flexural accentuation is an important sign.

Answer 11

ICD

Question 12

Retinoid dermatitis preferentially involves

Answer 12

Folds such as the nasolabial fold

Question 13

Y/N: Hand dermatitis always has an irritant component.

Answer 13

Yes

Question 14

Pathogenesis of ICD (3 steps)

Answer 14

1. Epidermal insult
2. Danger signals
3. Potential for allergic sensitization

Question 15

Damaged keratinocytes release danger signals termed

Answer 15

Alarmins

Question 16

Innate signal from disrupted skin barrier, together with the irritant signal of a potent antigen, may drive dendritic cells into the dermis and promote

Answer 16

Immunologic tolerance

Example: Patients with atopic dermatitis are less likely to exhibit dermatitis to the potent allergen in poison ivy that is also a strong irritant.

Question 17

If initial food exposure is on _____, tolerance develops.

Answer 17

Mucosa

Question 18

Measure of the ability of the skin to maintain homeostasis of fluids

Answer 18

Transepidermal water loss

Question 19

Has been studied to help differentiate irritant from allergic contact dermatitis in vivo, but is not currently used in practice

Answer 19

Confocal microscopy

Question 20

Most allergens on standard screening tests are _____ potency allergens

Answer 20

Strong or medium

Question 21

Irritant dermatitis often resolves despite continued exposure to the irritant; this is known as

Answer 21

Hardening

Question 22

Suggest that _____ replace the term barrier cream

Answer 22

Prework cream

Question 23

Topical corticosteroids are frequently used, but chronic use may impair barrier function by

Answer 23

Thinning the epidermis

Question 24

Considered second-line therapy for chronic hand dermatitis in Europe

Answer 24

Alitretinoin

Question 25

Should substitute for hand washing especially in cold seasons

Answer 25

Alcohol-based hand sanitizers

Question 26

Cotton gloves are recommended under occlusive gloves if the duration of glove usage is longer than

Answer 26

10 minutes

Question 27

Y/N: Acute dermatitis has a worse prognosis than chronic dermatitis.

Answer 27

No - chronic dermatitis had a worse prognosis