Atopic Dermatitis, Eczematous Dermatitis and Contact Dermatitis -Pham

Question 1

What class of corticosteroid creams should be used for the face, body folds and genetalia?

Answer 1

class 7

hydrocortisone 1% cream or ointment for children

Question 2

What can happen if you use a steroid cream for too long a period of time?

Answer 2

Tachyphylaxis (medication does not work as well as before)

Question 3

What class of steroid creams are most commonly used in adults? What about for the face and body folds?

Answer 3

can use class 1-7 steroid creams (Clobetasol cream (class 1) can be used BID for body and Fluocononide (class 2) can be used BID for the body too)

Question 4

*What are important treatment options for everyday use in atopic dermatitis? Flare-ups?

Answer 4

Everyday use=hypoallergenic cleansers and moisturizers (cetaphil restoraderm)

Flare-ups: Corticosteroid creams

Question 5

What is eczema herpeticum? What is the treatment in adults?

Answer 5

Herpes simplex 1 infection in patients with atopic dermatitis
–> may have high fever and LAD and can develop super infection (from the openings in the skin from the herpes infection)

-tx: Valtrex 1 g bid and Acyclovir 200mg 5x/day

Question 6

What is pityriasis alba? What is the treatment of choice?

Answer 6

-hypopigmented, scaly, eczematous patches
-tx:
-Elidel cream or
Protopic ointment (for treatment AND re-pigmentation)

Question 7

*What is Asteatotic Eczema? What is the treatment?

Answer 7

Dry skin with fissures

treatment=Aquaphor ointment under occlusion to help cure the fissures

Question 8

What is Dyshidrotic Ezcema? What is the treatment?

Answer 8

chronic vesiculobullous dermatitis –> small vesicles on the lateral aspects of the fingers, palmar hands and soles

-tx: steroid cream bid (elidel cream or pro topic ointment) and Oral Erythromycin

Question 9

What is Prurigo Nodularis? What is the treatment?

Answer 9

-picker’s nodules ==> picking and scratching secondary to itching because of something else (atopic dermatitis)==> hyperkeratotic firm nodules

tx: -Intralesional Kenalog injections
- corticosteroid creams

Question 10

*What is keratosis Pilaris? What is the treatment?

Answer 10

• follicular plugging common on arms, cheeks, thighs and buttocks.
• common FmHx of asthma, atopic dermatitis

-Tx: Lac-hydrin lotion/cream (lactic acid)

Question 11

What is stasis dermatitis? What is the treatment?

Answer 11

Stasis dermatitis occurs in pts with venous insufficiency of the lower extremities
-tx: steroid creams (TMC)

Question 12

What is Rhus Dermatitis? What is the treatment?

Answer 12

• the most common form of allergic contact dermatitis to plants
• caused by urushiol (in sap)

-tx: domeboro soaks (astringent wet compresses) –> dry out the bullae