Contact Derm

Question 1

What are the two main types of contact derm

Answer 1

Irritant - damages barrier

Allergic- absorbs the allergen

Question 2

How do you dx Contact Derm

Answer 2

Patch testing allergy referral

Question 3

Irritant dermatitis damages what skin layer

Answer 3

Stratum corneum

Question 4

What is the most common cause of allergic contact derm

Answer 4

Nickel

Poison ivy 2*

Question 5

What is the distribution of allergic contact derm

Answer 5

Well defined/sharply demarcated
-Linear
(Rhus – poison ivy, oak, sumac)
-Shaped (ring, watch)

Question 6

What is the tx approach to allergic contact derm

Answer 6

Avoidance

Cold wet compress if wet

Potent topical or oral steroids x 2 weeks

Antihistamines

Question 7

Define urticaria

Answer 7

Recurrent whealing of the skin

Question 8

What is the threshold for acute vs chronic urticaria

Answer 8

Acute less than 6 week

Chronic more

Question 9

Urticaria that only lasts 30-60 minutes

Think

Answer 9

Physical urticaria (from a trigger)

Question 10

What is the tx approach to acute urticaria

Answer 10

Avoidance

H1 blocker

(Treat anaphylaxis)

Question 11

What is the tx approach to chronic urticaria

Answer 11

2ng gen antihistamine

H2 blocker

Short course PO steroid

Elimination diet

Question 12

What is the differnce between acute, subacute, and chronic irritant dermatitis

Answer 12

Acute - vesicular and exudative

Acute to Subacute - inflamed, cracked, fissured skin

Chronic - scaly, flaky, lichenified with less erythema