Atopic dermatitis Flashcards
How does it present
ry skin and flares of erythematous, poorly demarcated patches that are itchy
Which areas are effected
In infants the cheeks are most commonly affected and the nappy area is usually spared. In older children and adults the flexures (bends of elbow and behind the knees) are commonly affected.
How is a diagnosis made
3 < criteria
Visible flexural eczema*
History of flexural eczema*
History of dry skin
History of asthma or allergic rhinitis (or history of atopy in 1st degree relative if <4 years)
Onset <2 years old (do not use if <4 years old)
or on the cheeks/extensors in children <18 months
How is it treated
Avoid irritants
Emollient’s
Steroid cream
Severe cases cyclosporin
What is Eczema herpeticum
ermatological emergency. It is caused by a disseminated HSV infection due to impaired skin protection as a result of atopic dermatitis.
What does eczema herpeticum look like
monomorphic vesicular rash which can ulcerate and crust. There may be systemic effects, such as fever. Diagnosis can be confirmed with a swab + Tzanck test.
How to treat
Treatment is with IV aciclovir
What can cause bacterial infection
caused by staphylocci/streptococci
What is erythroderma
Erythroderma is a dermatological emergency where there is widespread erythema affecting >90% of the skin surface. This can result in heat and fluid loss, causing hypothermia and systemic symptoms.
What are the causes
exacerbation of a pre-existing skin condition:
Dermatitis: Atopic dermatitis, seborrhoeic dermatitis, contact dermatitis
Psoriasis
Pityriasis rubra pilaris§
What does diary syndrome cause
cutaneous T-cell lymphoma which causes erythroderma, lymphadenopathy and hepatosplenomegaly. It is characterised by Sezary cells (atypical T cells) in the peripheral circulation.
How to manage erythroderma
supportively with fluids, emollients and by treating the underlying disease (e.g. steroid for an exacerbation of atopic dermatitis) under the guidance of a dermatology specialist
