Dermatitis

Question 1

Pathophysiology of dermatitis

Answer 1

Allergens that interact with APCs initiate inflammatory response
Scratching cycle
Main cytokines: IL- 4, IL-5, TNFa, IL-12
(Refer to flow diagram)

Question 2

Similarity and difference between Irritant and Allergic contact dermatitis

Answer 2

Both are exogenous forms of dermatitis

Allergic contact dermatitis is caused by an allergen, i.e. when removed the skin will clear up
Irritant contact dermatitis is related to frequent exposure to substances which damages skin e.g.. soap, detergents

Question 3

Common form of irritant contact dermatitis in infants?

Answer 3

Nappy rash

Question 4

How would you manage nappy rash?

Answer 4

Change nappies frequently
Allow nappy free periods
Use disposable nappies or cloth nappies with liner (more breathable) - helps keep skin dry
Clean baby's bottom at every change
Mild corticosteriod for inflammation
Dry skin- moisturise
Barrier cream if needed

Question 5

What is photo allergic dermatitis?

Answer 5

UV exposure activates a sensitising substances that is concentrated in the skin to become an active antigen

Common allergens: Perfume, sunscreens, sulfonamides, quinolones

Question 6

Atopic dermatitis: Signs and Symptoms

Answer 6

Red, scaly eruption
Acute: weeping and crusted
Chronic: thickened skin with dryness and cracking

Question 7

What is asteatotic eczema?

Answer 7

Occurs in the elderly due to low lipid and water content in skin which leads to dryness and eczema
Exacerbated by soap, central heating, conditions that can dry out the skin

Tx: Use a thick moisturiser

Question 8

Eczema management

Answer 8

Avoid precipitating factors
Emollients
Soap substitutes
Corticosteriods

Question 9

Mild corticosteriods

Answer 9

Hydrocortisone 0.5% and 1%

Question 10

Moderate corticosteriods

Answer 10

Betamethasone valerate 0.02% 0.05% (Betnovate)
Methylprednisolone 0.1% (Advantan)
Clobetasone butyrate 0.05% (Eumovate)
Triamcinolone acetonide 0.02% (Aristocort)

Question 11

Potent corticosteriods

Answer 11

Betamethasone diproprionate 0.05% (Diprosone)
Betamethasone valerate 0.1% (Betnovate)
Mometason furoate 0.1% (Elocon)
Triamcinolone acetonide 0.1%

Question 12

Very Potent corticosteriods

Answer 12

Betamethasone dipripionate 0.05% in optimsed vehicle