Dermatitis

Question 1

define atopic dermatitis (eczema)

Answer 1

a chronic and atopic skin condition that occurs due to defects in the continuity of the skin barrier - causing inflammation and itching

Question 2

describe a flare period of eczema

Answer 2

dry skin with erythematous poorly demarcated itchy patches

Question 3

describe the physiology of atopic dermatitis

Answer 3

mutations of filaggrin gene cause loss of outer skin barrier function, allowing entrance of irritants and allergens that trigger a hypersensitivity IgE reaction

Question 4

risk factors of atopic dermatitis

Answer 4

+ve family history of atopic conditions

hormonal changes

Question 5

clinical features of atopic dermatitis

Answer 5

itchy skin distributed commonly around the flexures
acute skin changes (e.g, erythema, papules and scaling)
chronic skin changes
(e.g. thickening + fissure formation)

Question 6

clinical criteria for atopic dermatitis

Answer 6

12 months of itchy skin and 3-5 of the following:

• visible flexural eczema
• history of flexural eczema
• history of dry skin
• history of asthma or allergic rhinitis
• onset <2yrs of age

Question 7

conservative management of atopic dermatitis

Answer 7

patient education
avoidance of causative/exacerbating factors
use of emollients/creams

Question 8

examples of creams used in atopic dermatitis

Answer 8

E45
oilatum
aveeno
cetraben

Question 9

examples of emollients

Answer 9

50:50
epaderm ointment
hydromol ointment

Question 10

medical management of atopic dermatitis

Answer 10

topical steroid

emollient antimicrobial

Question 11

management of severe cases of atopic dermatitis

Answer 11

referral to dermatology who can consider:

• phototherapy
• immunosuppression
• biologics

Question 12

define seborrhoeic dermatitis

Answer 12

an inflammatory skin condition occurring in areas rich in sebaceous glands that causes ill-defined greasy flakey scales on an erythematous background

Question 13

risk factors of seborrhoeic dermatitis

Answer 13

family history 
oily skin 
immunosuppression 
neurological disease 
psychological disorder

Question 14

clinical features of seborrhoeic dermatitis

Answer 14

well defined patches of erythema and associated white/yellow flakes
can be itchy

Question 15

clinical features of seborrhoeic dermatitis in paediatrics (a.k.a. cradle cap)

Answer 15

appearance of diffuse yellow and greasy scales

Question 16

indications for investigations in seborrhoeic dermatitis

Answer 16

if suspect HIV or lupus, do:

• blood tests
• skin scrapings
• skin biopsies

Question 17

management of seborrhoeic dermatitis (scalp)

Answer 17

kerytolytic preparations

medicated shampoo

Question 18

management of seborrhoeic dermatitis (face, ears, chest + back)

Answer 18

antifungal cream (ketoconazole)
topical corticosteroid
topical calcineurin inhibitor

Question 19

define psoriasis

Answer 19

a systemic immune-mediated and inflammatory skin disease that follows a relapsing-remitting course

Question 20

describe plaque psoriasis

Answer 20

presence of thickened erythematous plaques and silver scales on the extensors and scalp

Question 21

describe guttate psoriasis

Answer 21

commonly occurs in children
presents as small raised papules across the trunk and limbs
can be triggered by strep throat

Question 22

triggers of psoriasis

Answer 22

beta-blockers 
anti-malarials 
lithium 
NSAIDs 
psychological stress
skin trauma

Question 23

clinical features of psoriasis (light skin)

Answer 23

itchy, well-demarcated circular and elevated lesions (often salmon in colour with overlying white scales)
changes in the nails

Question 24

management of psoriasis

Answer 24

potent topical steroid
topical Vitamin D
advise lifestyle modifications

Question 25

describe contact dermatitis

Answer 25

an inflammatory skin reaction in response to exposure to an external stimulus/causative agent

Question 26

describe irritant contact dermatitis

Answer 26

an inflammatory response occurring after repeated exposure to an irritant

Question 27

describe allergic contact dermatitis

Answer 27

a type IV delayed hypersensitivity reaction to allergens

Question 28

clinical features of an irritant contact dermatitis

Answer 28

onset < 48hrs
burning/stinging sensation of rash present in exposed area
resolution occurs after irritant removal

Question 29

clinical features on an allergic contact dermatitis

Answer 29

delayed development onset
redness + itching sensation
rash occurs in various areas

Question 30

management of contact dermatitis

Answer 30

advise avoidance of irritant/allergen
prescribe use of simple emollient
topical corticosteroid