Derm - Eczema Flashcards
What are the major endogenous types of Eczema?
Atopic Seborrhoeic Discoid Pompholyx Varicose
What could cause eczema in general to flare up?
- Infection
- Environment e.g. hot/cold
- Pets (if sensitized)
- Teething
- Stress
- Idiopathic
In general how do you treat eczema?
- Topical Steroids
- Emollients
- Soap substitute
If topical steroids don’t help:
-steroid sparing agents: Protopic ointment, Elidel cream - UVB Phototherapy - Immunosuppresants- methotrexate Biologics: Dupilumab
What are the dangers of steroids?
Skin thinning if used for a prolonged time
steroids available
Mild: Hydrocortisone.
Moderate: Eumovate
Potent: Betnovate
Very potent: Dermovate
Risk factors for atopic dermatitis?
Another ATopic TRiad condition (asthma or hayfever)
FH of atopic conditions
What causes seborrheic dermatitis?
Malassezia Yeast
How does seborrheic appear?
On the scalp/face, mainly in <3month olds
Its ass with cradle cap
How do we treat seborrheic dermatitis?
emollients
daktorcot ointment
Ptotopic ointment
+ Antifungal creams/shampoos
Describe discoid eczema?
treatment?
Scattered annular/circular itchy patches
Separate to or part of atopic eczema
need potent topical steroid- Bentovate C ointment
List some allergens causing Allergic Contact Dermatitis?
Milk Soy Peanuts Eggs Wheat Dust Mite Pet Dander Pollen
When would you suspect an allergy in eczema?
- Immediate reaction to food
- GI problems
- FTT
- Unresponsive to treatment
- Generalised itching
- Atopy
How do we test for allergy?
Blood test for specific IgE
Skin Prick & PAtch testing
How do you manage an allergy?
Dietary elimination for 8wks (refer to dietitian
Eczma presentation?
red, dry, itchy skin eruption
flares and settles intermittently
if get atopic eczema before 3 months what should you be thinking about?
CMPA (cows milk protein allergy)
atopic eczema presentation
widespread diffuse scale erruption
VERY itchy
what is eczema from?
barrier defect
water loss
Fillaggrin mutation
How much is one FTU?
0.5g
When to suspect Type 1 food allergy?
Immediate reaction (type 1 reaction)
lip swelling,
facial redness/itching]anaphylactic symptoms
when to suspect type 2 food allergy?
worsening of eczema 24-48hours after injestion
GI proboems
failure to thrive
severe eczema unresponsibve to treatment
severe generalised itching- even if skin looks clear
8 week old baby with severe widespread eczema
no response to hydrocortisone applied sparingly
strong FH of Atopy
treatment?
Eumovate daily for 5 days
Betnovate once daily for 7-10 days
Hydromol ointement all over
Hydromol bath and shower for bathing
consider CMPA and mum trial diary free diet
How to use steroids
Should be used in finger tip units for:
- 1/day for 1-2wks
- Then if it improves continue using on alt days for a few days
- If stubborn areas you can use twice weekly for those areas
more sensitive areas- need to limit steroid use
