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Ambulatory Care Skills I > Contact Dermatitis Exam 3 > Flashcards

Contact Dermatitis Exam 3 Flashcards

1
Q

Characterized by inflammation, redness, burning, itching, and pustule formation on skin

A

Contact Dermatitis

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2
Q

2 Types of Contact Dermatitis

A

Irritant Contact Dermatitis (ICD)

Allergic Contact Dermatitis (ACD)

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3
Q

Inflammatory reaction due to exposure to irritant substances

A

Irritant Contact Dermatitis (ICD)

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4
Q

Immunologic reaction caused by exposure to an antigen

A

Allergic Contact Dermatitis (ACD)

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5
Q

Mechanisms of ICD`

A

Disruption of skin barrier
Changes in cells of epidermis
Release of pro-inflammatory cytokines

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6
Q

Most commonly affected areas are __________ (often due to exposure)

A

Hands and face

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7
Q

______ % of cases have hand involvement

A

80%

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8
Q

Existing skin conditions ____________ can result in worse cases of ICD

A

Atopic Dermatitis

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9
Q

Can effect individuals of any age

Infants and elderly more at risk due to ________

A

thinner epidermal layers

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10
Q

________ can play a role in type of exposure

A

occupation

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11
Q

Substances associated with ICD

A 
Strong acids (hydrochloric, sulfuric)
Strong bases (sodium, potassium)
Detergents, soaps
Fiberglass
Oils
Urine/feces
Wood dust
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12
Q

Clinical Presentation of ICD

A 
Inflammation and swelling
Itching and burning
Rash 
Hyper/hypo-pigmentation
Scaling of skin, dryness
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13
Q

Goals of Therapy ICD

A

Remove the offending agent
Relieve inflammation and irritation
Educate patient on prevention and treatment

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14
Q

Non-Pharmacologic Therapy for ICD

A

Flush area with tepid water and mild soap

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15
Q

Non-Pharmacologic Prevention for ICD

A

Wear protective clothing

Use of emollients and barrier creams

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16
Q

Pharmacologic Treatment Options

A

Emollients
Colloidal Oatmeal Baths
Topical Corticosteroids

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17
Q

Immunologic reaction caused by allergen-specific T lymphocytes

A

Allergic Contact Dermatitis (ACD)

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18
Q

T cells migrate to site of contact and release inflammatory mediators

A

Allergic Contact Dermatitis (ACD)

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19
Q

ACD requires ________

A

sensitization

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20
Q

Induction Phase of ACD

A

Immune system sensitized by first exposure to antigen

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21
Q

Elicitation Phase of ACD

A

Cell-mediated, type IV delayed hypersensitivity reaction

Rash and symptoms typically appear within 24-48 hours, can take days

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22
Q

Epidemiology of ACD is frequency based on exposure such as

A

Occupation
Hobbies/Habits
Regional allergens

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23
Q

Epidemiology of ACD affects all ages, races and sexes and usually start to see around ______ years old

A

2-3 years old

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24
Q

Clinical Presentation of ACD

A

Localized to site of skin contact with allergen

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25
Q

Symptoms may not appear for hours to days

A

delayed hypersensitivity with ACD

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26
Q

Symptoms of ACD

A 
Severe itching
Rash (skin red, swollen, and hot)
Excessively dry skin
Fluid-filled blisters
Oozing blister that leave crust or scales
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27
Q

Substances Associated with ACD

A 
Poison Ivy, Oak, Sumac
Metal (Nickel)
Lanolin
Latex
Neomycin
Rubber
Fragrances 
Adhesives
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28
Q

Among most common causes of ACD

A

Poison Ivy, Oak, Sumac

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29
Q

Dermatitis reaction is caused by exposure to

A

urushiol

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30
Q

urushiol can only be released through damage to the

A

plant

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31
Q

For Poison Ivy, Oak, & Sumac All members of the Toxicodendron genus. Exist mostly as

A

shrubs and vines

32
Q

Important to wash hands after potential exposure to poison ivy, oak & sumac to prevent transfer to other body sites such as

A

eyes
lips
genitalia

33
Q

Urushiol Induced Dermatitis has a highly variable presentation based

A

on patient sensitivity and extent of exposure

34
Q

Urushiol can form

A

papules, plaques, or fluid-filled vesicles

35
Q

______ cannot cause further transfer of dermatitis

A

Vesicular fluid

36
Q

Complications of ACD include

A

secondary infections

37
Q

For ACD scratching can further damage the dermal layer, creating ________-

A

open lesions

38
Q

Lesions can then become infected with microbes from the skin like

A

Staphylococcus aureus
Group A Streptococcus
Escherichia coli

39
Q

Goals of Therapy for ACD

A

Remove offending agent
Treat inflammation
Relieve itching that may lead to open lesions
Relieve accumulation of debris from oozing and crusting

40
Q

Exclusions for Self-Treatment for ACD

A

< 2 years old
> 20% Body Surface Area (BSA)
Dermatitis present > 2 weeks
Presence of numerous bullae
Discomfort in genitalia from itching, redness, swelling, or irritation
involvement of or itching mucous membranes
failure of self treatment after 7 days
low tolerance for pain, itching, or discomfort

41
Q

What formula is used for BSA

A

Mosteller Formula

42
Q

Non-Pharmacologic Treatment for ACD

A

Cold or tepid shower to help reduce itching

43
Q

Non-Pharmacologic Prevention for ACD

A

Avoid offending agent

Protective clothing

44
Q

Pharmacologic Treatment for ACD

A 
Topical Corticosteroid (Hydrocortisone 1% cream)
Astringent compress 
Calamine products 
Colloidal oatmeal products 
Oral antihistamines
45
Q

Avoid using what for Pharmacologic Treatment for ACD

A

topical antihistamines
topical anesthetics
topical antibiotics

46
Q

Prevention of Poison Ivy, Oak, Sumac

A

Learn to identify Toxicodendron plants.
Eradicate them from your residence.
Use protective clothing and wash separately immediately after exposure
Use barrier products

47
Q

FDA approved protection against poison ivy/oak/sumac

A

Active Ingredient: Bentoquatum

IvyBlock Lotion

48
Q

Ivy Black Lotion application

A

Apply before 15 minutes before exposure and reapply every 4 hours.

49
Q

Contact Dermatitis in Pediatrics

A

similar to adults – pay attention to package

50
Q

Contact Dermatitis in Pregnancy

A

Short term use of topical agents generally considered safe

51
Q

Contact Dermatitis in Geriatrics

A

Avoid first generation antihistamines

52
Q

Follow up for ICD & ACD in

A

After 5 to 7 days of treatment

53
Q

Complete resolution for ICD & ACD may take up to

A

3 weeks

54
Q

When do contact provider for ICD & ACD?

A 
Rash increase in size
Symptoms worse 
Doesn't begin to improve within 7 days
Spreads to or involves other genitals
Covers extensive areas of the face or causes swelling of the eyelids
55
Q

Itching begins when for ICD?

A

later

56
Q

Itching begins when for ACD?

A

early

57
Q

Stinging/Burning begins when for ICD?

A

early

58
Q

Stinging/Burning begins when for ACD?

A

late or not at all

59
Q

Does Vesicles, Bullae, Papules present in ICD?

A

rarely

60
Q

Does Vesicles, Bullae, Papules present in ACD?

A

yes

61
Q

What is the time to rash after exposure for ICD?

A

minutes to hours

62
Q

What is the time to rash after exposure for ACD?

A

hours to days

63
Q

Appearance of symptoms in relation to exposure for ICD

A

initial or repetitive exposure

64
Q

Appearance of symptoms in relation to exposure for ACD

A

delayed

65
Q

Causative Substances for ICD

A

Water, urine, flour, detergent, hand sanitizer, soap, alkalis, acids, solvents, salts, oxidizer, surfactants

66
Q

Causative Substances for ACD

A

Toxicodendron plants, fragrances, nickel, latex, benzocaine, neomycin, leather

67
Q

Substance concentration at exposure important for ICD?

A

Yes, Important

68
Q

Substance concentration at exposure important for ACD?

A

Less important

69
Q

Mechanism of reaction of ICD

A

Direct tissue damage

70
Q

Mechanism of reaction of ACD

A

Immunologic reaction

71
Q

Common Location of ICD

A

Hand, wrists, forearms, diaper area

72
Q

Common Location of ACD

A

Anywhere that comes in contact with antigen

73
Q

Presentation of ICD

A

No clear margins

74
Q

Presentation of ACD

A

Clear margins based on offending agents

75
Q

Who can be affected with ICD?

A

anyone

76
Q

Who can be affected with ACD?

A

patients with allergy

Ambulatory Care Skills I (32 decks)

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