Dermatitis Flashcards
define atopic dermatitis (eczema)
a chronic and atopic skin condition that occurs due to defects in the continuity of the skin barrier - causing inflammation and itching
describe a flare period of eczema
dry skin with erythematous poorly demarcated itchy patches
describe the physiology of atopic dermatitis
mutations of filaggrin gene cause loss of outer skin barrier function, allowing entrance of irritants and allergens that trigger a hypersensitivity IgE reaction
risk factors of atopic dermatitis
+ve family history of atopic conditions
hormonal changes
clinical features of atopic dermatitis
itchy skin distributed commonly around the flexures
acute skin changes (e.g, erythema, papules and scaling)
chronic skin changes
(e.g. thickening + fissure formation)
clinical criteria for atopic dermatitis
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
conservative management of atopic dermatitis
patient education
avoidance of causative/exacerbating factors
use of emollients/creams
examples of creams used in atopic dermatitis
E45
oilatum
aveeno
cetraben
examples of emollients
50:50
epaderm ointment
hydromol ointment
medical management of atopic dermatitis
topical steroid
emollient antimicrobial
management of severe cases of atopic dermatitis
referral to dermatology who can consider:
- phototherapy
- immunosuppression
- biologics
define seborrhoeic dermatitis
an inflammatory skin condition occurring in areas rich in sebaceous glands that causes ill-defined greasy flakey scales on an erythematous background
risk factors of seborrhoeic dermatitis
family history oily skin immunosuppression neurological disease psychological disorder
clinical features of seborrhoeic dermatitis
well defined patches of erythema and associated white/yellow flakes
can be itchy
clinical features of seborrhoeic dermatitis in paediatrics (a.k.a. cradle cap)
appearance of diffuse yellow and greasy scales
indications for investigations in seborrhoeic dermatitis
if suspect HIV or lupus, do:
- blood tests
- skin scrapings
- skin biopsies
management of seborrhoeic dermatitis (scalp)
kerytolytic preparations
medicated shampoo
management of seborrhoeic dermatitis (face, ears, chest + back)
antifungal cream (ketoconazole)
topical corticosteroid
topical calcineurin inhibitor
define psoriasis
a systemic immune-mediated and inflammatory skin disease that follows a relapsing-remitting course
describe plaque psoriasis
presence of thickened erythematous plaques and silver scales on the extensors and scalp
describe guttate psoriasis
commonly occurs in children
presents as small raised papules across the trunk and limbs
can be triggered by strep throat
triggers of psoriasis
beta-blockers anti-malarials lithium NSAIDs psychological stress skin trauma
clinical features of psoriasis (light skin)
itchy, well-demarcated circular and elevated lesions (often salmon in colour with overlying white scales)
changes in the nails
management of psoriasis
potent topical steroid
topical Vitamin D
advise lifestyle modifications
