CD, Eczema, SD Flashcards
Types of Dermatitis
Atopic Dermatitis (Eczema)
Contact Dermatitis
Seborrheic Dermatitis
Photodermatitis
(Stasis dermatitis, multifactoral)
Chronic inflammatory skin condition characterized by pruritis, erythematous and scaly lesions often localized to flexural surfaces and may be associated w/ personal/family hx of atopic disease (asthma, allergic rhinitis)
Atopic Dermatitis
Genetic defect in ______ disrupting epidermis in Atopic dermatitis –> immune cells/antigens communicating
Filaggrin
Hallmark: Itching, tx w/ topical glucocorticoids Rx
Atopic dermatitis
Clinical features of atopic dermatitis
Pruritis
Facial/extensor papulovesicles in infancy
Flexural lichenification in adults and older children
Chronic-relapsing course
personal or family hx of atopic dz
Differential Dx for AD
Congenital, chronic dermatoses, infection/infestation, malignancies, immunodeficiencies, metabolic disorders, immunologic disorders
Tx for AD
Cutaneous hydration-emollients
Topical Glucocorticoids Rx
Identify and eliminate flare factors
Tx of pruritis (antihistamines, tar)
Second line -
protopic, topical immunomodulator inhibits Tcell activation
Eliden - calcineurin inhibitor
Complications of AD
eye, infections, hand dermatitis, exfoliative dermatitis, impetigo, herpes inf, contact sensitization
Prognosis for AD
spontaneous resolution after age 5 in 40%, 84% outgrow by adolescence
worse if more sxs of atopy
Hallmark: Linear, some itching too
Contact Dermatitis
Inflammatory reaction of skin precipitated by exogenous chemical
Contact dermatitis
Two types of CD
Irritant - direct toxic effect
Allergic - immunologic rexn that causes tissue inflammation (Type IV hypersensitivity)
Clinical features of acute vs. chronic
Acute - linear streaks of vesicles (poison ivy especially)
Chronic - lichenification, eczematous rexn
Differential for CD
Atopic dermatitis, seborrheic dermatitis, stasis dermatitis, fungal infec, bacterial cellulitis
Lab testing for CD
No testing for irritant
Patch testing for allergic CD
CD tx
Prevention-Allergen avoidance
Symptomatic tx
physiochemical barriers
tolerance induction
Chronic, superficial inflammatory process affecting hairy regions of body (scalp, eyebrows and face especially)
Seborrheic dermatitis
One of the most common skin manifestations in patients with HIV, paralysis/quadriplegia, parkinsons
Seborrheic dermatitis
Two peaks of SD
Infancy in first 3 mo, adult 40-70
Clinical Features of SD
Bilateral, symmetrical Predilection for hairy regions Patches and plaques w/ indistinct margins Dandruff Uncommon to have hair loss
Differential Dx of SD
Atopic dermatitis, psoriasis, tinea capitis, SLE, rosacea, histiocytosis X
Drugs causing SD rash
Arsenic, gold, methyldopa, cimetidine, neuroleptics
Physical factors for SD
Seasonal variation (worse in autumn, winter) Those who get PUVA for psoriasis at risk (mask face)
Tx goals for SD
Loosening and removal of scales and crusts Inhibition of yeast colonization Control of secondary inf Reduction of erythema and itching Control rathe than cure
Tx of SD for infants (cradle cap)
Removal of crusts with 3-5% salicylic acid in olive oil or water soluble base
Warm olive oil compresses
low potency glucocorticoids
mild baby shampoos
Drying lotions in skin folds, tx for candidiasis
Tx of SD for adults
Anti-inflammatory, antifungal, kerolytics
daily shampoo w/ special ingredients
crusts - can remove overnight w/ topical glucocorticoids or salicylic acid in water soluble base
Tinctures/alcohol AGGRAVATE
Antifungals (imidazoles, metronidazole)
Immune based dermatitis in which UV light alters antigen to make it an effective immunogen resulting in typer IV cell mediated reactions
Photodermatitis
Commonly seen with _____ and _______ - Photodermatitis
thiazide diuretics and tetracyclines
Tx photodermatitis
stop med, UVA/UVB blocker sunscreen
