Contact Dermatitis Flashcards
What is eczema herpeticum?
Eczema herpeticum describes a severe primary infection of the skin by herpes simplex virus 1 or 2.
Who is more commonly affected by eczema herpeticum?
It is more commonly seen in children with atopic eczema.
What are the typical symptoms of eczema herpeticum?
It often presents as a rapidly progressing painful rash.
What are the characteristic lesions seen on examination?
Monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameter.
Why is eczema herpeticum considered serious?
As it is potentially life-threatening, children should be admitted for IV aciclovir.
What percentage of children are affected by eczema?
Eczema occurs in around 15-20% of children.
At what age does eczema typically present?
Eczema typically presents before 2 years of age.
What percentage of children see eczema clear by 5 years of age?
Around 50% of children see eczema clear by 5 years of age.
What percentage of children see eczema clear by 10 years of age?
Around 75% of children see eczema clear by 10 years of age.
What are common features of eczema?
Eczema features an itchy, erythematous rash and repeated scratching may exacerbate affected areas.
In infants, where is eczema often affected?
In infants, the face and trunk are often affected.
In younger children, where does eczema typically occur?
In younger children, eczema often occurs on the extensor surfaces.
In older children, where is eczema typically distributed?
In older children, a more typical distribution is seen with flexor surfaces affected and the creases of the face and neck.
What is the management strategy for eczema?
Management includes avoiding irritants and using simple emollients.
How much emollient should be prescribed?
Large quantities should be prescribed, e.g., 250g/week, roughly in a ratio of 10:1 with topical steroids.
How should emollients and topical steroids be applied?
Emollients should be applied first, followed by waiting at least 30 minutes before applying the topical steroid.
Which form of emollient soaks into the skin faster?
Creams soak into the skin faster than ointments.
How can emollients become contaminated?
Emollients can become contaminated with bacteria; fingers should not be inserted into pots.
What is a method used in severe eczema cases?
Wet wrapping is a method used, involving large amounts of emollient (and sometimes topical steroids) applied under wet bandages.
What medication may be used in severe cases of eczema?
In severe cases, oral ciclosporin may be used.
What is the recommendation for using topical steroids for eczema?
Use the weakest steroid cream which controls the patient’s symptoms.
What are the categories of topical steroids by potency?
Mild, Moderate, Potent, Very potent.
Name a mild topical steroid.
Hydrocortisone 0.5-2.5%.
Name a moderate topical steroid.
Betamethasone valerate 0.025% (Betnovate RD).
Name a potent topical steroid.
Betamethasone valerate 0.1% (Betnovate).
Name a very potent topical steroid.
Clobetasol propionate 0.05% (Dermovate).
What is the fingertip rule for topical steroids?
1 finger tip unit (FTU) = 0.5 g, sufficient to treat a skin area about twice that of the flat of an adult hand.
How many fingertip units are needed for the front and back of hands?
1.0 FTU.
How many fingertip units are needed for an entire leg and foot?
8.0 FTU.
What is the recommended amount of topical steroids for the face and neck?
15 to 30 g.
What is the recommended amount of topical steroids for both legs?
100 g.
