Dermatitis Flashcards
What are features of atopic dermatitis?
Manifests in early childhood
Itchy dry skin often affecting hands or flexor surfaces of the limbs
-extensor surfaces>flexor
Acute flares-increased pruritus, erythema, vesicles
Personal or family history of atopy
Weeping/pustules and fever- may suggest bacterial infection
What is the management of atopic dermatitis?
Generous use of emollients
Steroids during acute flares to achieve remission- weakest cream to control symptoms
Mild- hydrocortisone 0.5-2.5%
- if areas of dry skin and occasional itch
Moderate- Betnovate or Eumovate
- if dry skin with frequent itching and erythema
Potent- cutivate or betnovate (0.1%)
-if widespread dryness, severe itch, erythema and oozing/cracked skin
Very potent- demovate (0.05%)
What is the second line management for moderate-severe atopic dermatitis?
Topical tacrolimus for people >2 years who failed to respond to steroids and there is a risk of adverse effects from further steroid use
What are features of pompholyx eczema?
Eczema affecting the fingers, palms and soles
Intense pruritus and small vesicles/blisters
Normally caused by moisture e.g. sweating
Treat with potent steroids
What is seborrhoeic dermatitis?
Chronic dermatitis that is caused by over proliferation of normal skin fungus- Malassezia Furfur leading to inflammation
Associated with HIV and Parkinsons
What are clinical features of seborrhoeic dermatitis?
Symmetrical eczematous lesions occurring most commonly on skin areas
-eyebrows/nasolabial folds
- periorbital and behind the ears
- upper chest and back
Normally erythematous patches with flaking and scales
Dandruff
Otitis externa
Blepharitis
What is the management of seborrhoeic dermatitis of the scalp/beard?
1) Ketaconazole 2% shampoo
- or zinc pyrithione containing shampoo, coal tar
2) IF severe itching of scalp consider steroid- betnovate 0.1%
Scalp normally affected in children- normally self resolves if not emollient to losen followed by imidazole cream
What is the management of facial/body seborrhoeic dermatitis?
1) ketoconazole 2% or imidazole cream (clotrimazole)
Consider adding mild steroid for flares
Ketoconazole can not be used in children
What are features of irritant dermatitis?
Common non-allergic inflammation of skin secondary to contact with irritants such as cleaning products
Features- erythema/crusting
What are features of allergic dermatitis?
A T cell mediated type VI sensitivity reaction
Often occurs on scalp following application of hair dye or on skin from nickel exposure
Blistering/weeping eczema 24-48 hours post exposure
Diagnosed with skin patch testing
Treat with potent topical steroids
