DERM: Eczema

Question 1

what is eczema?

Answer 1

defects in the normal continuity of the skin barrier, leading to inflammation in the skin

Question 2

which types of eczema are endogenous?

Answer 2

Atopic
Discoid
Pompholyx
Gravitational
Seborrhoeic

Question 3

which types of eczema are exogenous?

Answer 3

Irritant
Allergic
Photodermatitis

Question 4

what is atopic eczema?

Answer 4

Often presents in infancy but can start at any time

Chronically relapsing

Association with other atopic disease (atopic triad = eczema, asthma, hay fever).

Question 5

what are some features of infantile eczema?

Answer 5

• Usually starts on the face
• Often nappy area relatively spared
• Once crawling often affects the knees
• Secondary infection common

Question 6

what is discoid eczema?

Answer 6

a type of eczema that that causes skin to become itchy, swollen and cracked in circular or oval patches

Question 7

what is pompholyx eczema?

Answer 7

a type of eczema that is usually restricted to the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy watery blisters, mostly affecting the sides of the fingers, the palms of the hands and the soles of feet.

Question 8

what is gravitational eczema?

Answer 8

a common form of eczema that occurs on the lower extremities in patients with chronic venous insufficiency

Question 9

which type of eczema occurs in patients with chronic venous insufficiency?

Answer 9

gravitational/varicose eczema

e.g. people with varicose veins

Question 10

what is seborrhoeic eczema?

Answer 10

a type of eczema that makes your skin red, flaky and itchy. It affects areas of your skin that tend to be greasier, such as your face, scalp and centre of your chest.

Question 11

which type of eczema affects areas of your skin that tend to be greasier e.g. scalp and face?

Answer 11

seborrhoeic eczema

Question 12

what is photodermatitis?

Answer 12

sometimes referred to as sun poisoning or photoallergy, is a form of allergic contact dermatitis in which the allergen must be activated by light to sensitize the allergic response, and to cause a rash or other systemic effects on subsequent exposure.

Question 13

which drugs can cause induced photodermatitis?

Answer 13

Thiazide diuretics
Tetracyclines
NSAIDS

Question 14

what is the main complication of dermatitis or eczema?

Answer 14

infection

Question 15

how would you conduct a physical examination of eczema?

Answer 15

• Inspect
• Describe
  (erythema, dryness,excoriation,oozing,
  lichenification, oedema)
• Palpate
  (temperature)
• Systematic check
  (nails, scalp, hair, mucus membranes)

Question 16

what is the management of eczema?

Answer 16

• Look at aggravating factors
• Reduce irritants
• Look for evidence of secondary infection
• Patient education

Question 17

what is the first line treatment of eczema?

Answer 17

Emollients

Topical steroids

Topical immunomodulators (calcineurin inhibitors)

Question 18

what is the second line treatment of eczema?

Answer 18

Antibiotics for secondary infection

Oral steroids

Phototherapy

Immunosuppresants