Atopic Dermatitis

Question 1

What are the 3 conditions in the atopic ‘march’?

Answer 1

Eczema - begins in infancy
Asthma - usually after age of 2
Hay-fever (perennial rhinitis) - from 7 years
Food allergy is also in the atopic ‘march’

Question 2

What is filaggrin?

Answer 2

Protein present in keratohyalin granules in granular layer of the epidermis which helps in terminal differentiation of cells

Question 3

Prevalent filaggrin mutations can cause what to occur?

Answer 3

Ichthyosis vulgaris

Question 4

What features does ichthyosis vulgaris have?

Answer 4

Dry skin

Hyperlinear palms

Question 5

How do you manage eczema?

Answer 5

Reduce allergens/irritants
Lot of moisturisers
Topical corticosteroids (TCS)
Cotton clothes & bedding

Question 6

What are some side effects of topical corticosteroids?

Answer 6

Skin thinning
Increased skin infections
Telangiectasia and acne

Question 7

If moderate eczema is present how would you treat?

Answer 7

Emollients + moderate TSC and possibly calcineurin inhibitors

Question 8

If severe eczema is present how would you treat?

Answer 8

Emollients + potent/very potent TCS (short term) + specialist help

Question 9

What paste is impregnated into the cotton used in bandages for severe eczema?

Answer 9

Zinc oxide

Question 10

What is the treatment for eczema herpeticum?

Answer 10

Emergency referral

Immediate oral or systemic aciclovir

Question 11

Describe eczema herpeticum?

Answer 11

Monomorphic rash