Atopic Eczema Flashcards
Define Atopic Eczema
A chronic inflammatory T-Cell mediated condition of the skin in response to environmental allergens
What are the features of eczema pathology? [4]
Spongiosis - Intercellular Oedema
Acanthosis - Thicking of epidermis
Inflammation
Sites of atopic eczema: explain difference in presentation between infants and children/adults
Infants: scalp, face, trunk, extensor surfaces of limbs
Children and adults: flexor surfaces of limbs
What can trigger/worsen atopic eczema? [3]
Stress
Cold or Heat
Allergens e.g. pollen
How does Eczema present? [3]
Itchy erythematous dry scaling patches >
Exudative, erythematous and vesicular during flares >
Cause excoriations and lichenification if chronic scratching
Main modalities of eczema treatment [7]
- Education (Causative/exacerbating factors), avoid allergens
- Emollients/Soap susbstitutes
- Topical Steroids
- Systemic Immunosuppression
- Anti-histamines
- Anti-microbials
- UVB phototherapy
What topical steroids could be used for Eczema?
How to use topical steroids [4]
Hydrocortisone - low potency
Eumovate - moderate potency
Betamethasone - High potency
Daily for 1-2 weeks >
Alternate days if improvement >
Twice weekly >
If stubborn or persistent areas, back to daily
What are the types of systemic immunosuppression for Eczema [4]
Azithioprine
Ciclosporin
Methotrexate
Calcineurin inhibitors e.g. Tacrolimus
Eczema etiology [2]
Abnormality in filaggrin gene which binds keratin filaments together and involved in moisturisation;
Loss leads to loss of skin barrier function and water loss meaning irritants can penetrate
