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Dermatology > Allergy and the skin > Flashcards

Allergy and the skin Flashcards

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Dermatology Board Prep flashcards
1
Q

What is hypersensitivity?

A

An exaggerated immune response which causes collateral damage to oneself

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2
Q

Explain how hypersensitivity is classified (mediated, mechanism and common example)

A
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3
Q

What is an allergy reaction?

A

An immune system response to an environmental antigen which is normally harmless

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4
Q

Allergy incidence is increasing. What is thought to be the cause of this?

A

Hygiene hypothesis etc

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5
Q

What is the timeframe for a type 1 reaction?

A

Minutes up to two hours

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6
Q

What are the routes of exposure for a type 1 allergic reaction?

A

Direct skin contact, inhalation, ingestion & injection

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7
Q

What is the defining feature of type 1 allergic reaction history?

A

Consistant reaction with every exposure

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8
Q

How does type 1 allergic reaction present?

A

Urticaria, angioedema, wheezing/asthma, anaphylaxis

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9
Q

What are the features of urticaria?

A

Itchy, hive-like lesions which appear within an hour of exposure and last for several hours after

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10
Q

What are the features of angioedema?

A

Non-itchy, non-pitting localised swelling of subcutaneous tissue/mucous membrane

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11
Q

What is anaphylaxis?

A

Severe/life-threatening generalised/systemic hypersensitivity response involving the airways, breathing and circulation (most commonly with skin & mucosal involvement)

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12
Q

What investigations are indicated for suspected type 1 allergic reaction?

A

Specific IgE (RAST), skin prick testing, challenge test, serum mast cell tryptase level (during anaphylaxis)

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13
Q

What are the advantages of skin prick testing?

A

Very specific, cheap & easy, low chance of inducing anaphylaxis

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14
Q

How can type 1 allergic reaction be managed?

A

Avoidance, anti-histamines, corticosteroids, adrenaline autoinjector, sodium chromoglycate (mast cell stabiliser), immunotherapy, medic alert bracelet, education

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15
Q

When would an adrenaline autoinjector be given?

A

History of anaphylaxis or high risk patient with asthma

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16
Q

How many adrenaline autoinjectors should a patient be given?

A

Two

17
Q

Name three drugs which cause non-immune mediated mast cell degranulation

A

NSAIDs, morphine & aspirin

18
Q

What is the timeframe for a type 4 hypersensitivity reaction?

A

24-48 hours after exposure

19
Q

What are the routes of exposure for type 4 allergic reaction?

A

Direct skin contact, airborne contact and injection

20
Q

How do type 4 allergic reactions typically present?

A

Well defined rashes in areas exposed to allergen

21
Q

Where do lichenoid allergic type 4 reactions typically present? Give an example of an allergen that might cause this

A

Mucous membranes (mouth most commonly). Amalgam fillings

22
Q

Type 4 allergic reactions of the skin are usually called what?

A

Allergic contact dermatitis

23
Q

What investigations are indicated for suspected type 4 allergic reaction?

A

Patch testing

24
Q

What are the causes of dermatitis?

A

Allergens, endogenous (atopy), irritant & infectious

25
Q

What is irritant contact dermatitis?

A

Non-immunologically mediated reaction caused by abrasive/irritating/directly traumatic agents

26
Q

Irritant contact dermatitis and allergic contact dermatitis both require sensitization to the allergen/irritant before a visable reaction occurs. T/F

A

False - irritant contact dermatitis does not require prior sensitisation

27
Q

What are the typical patterns of irritant contact dermatitis?

A

Dependant on exposure

28
Q

Give 2 common examples of irritant contact dermatitis

A

Nappy rash & lip lick dermatitis

29
Q

There is much overlap between irritant and allergic contact dermatitis. T/F

A

True

30
Q

Give two examples of endogenous skin conditions. What are some differences between the two?

A

Atopic eczema (dry skin in flextural distribution) & psoriasis (scaly plaques on extensor surfaces)

31
Q

How is contact dermatitis managed?

A

Avoidance/minimisation, emollients, topical steroids, UV phototherapy, immunosuppressants

32
Q

Is prevelance of allergic reaction increasing or decreasing?

A

Increasing

Dermatology (26 decks)

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