Dermatitis Flashcards

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1
Q

Hyperkeratosis

A

Increased thickness of keratin layer

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2
Q

Parakeratosis

A

Persistence of nuclei in the keratin layer

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3
Q

Acanthosis

A

Increased thickness of epidermis

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4
Q

Papillomatosis

A

Irregular epithelial thickening

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5
Q

Spongiosis

A

Oedema between keratinocytes

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6
Q

Dermatitis

A

Skin lesions with similar clinical & pathological features but different PATHOGENETIC MECHANISMS (i.e. different causes)

Spectrum of disease.

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7
Q

Acute phase dermatitis

A

> Papulovesicular
Red (erythematous) lesions
Oedema (spongiosis)
Ooze or scaling and crusting

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8
Q

Chronic phase dermatitis

A

Thickening (lichenification)
Elevated plaques
Increased scaling

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9
Q

General features of Dermatitis

A

Itchy
Ill defined
Erythematous
Scaly

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10
Q

In drug reaction-related Dermatitis, what type of cells are present?

A

Eosinophils

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11
Q

Contact Allergic Dermatitis

A

One of the most common types of dermatitis

Very common.

  • in response to chemicals, topical, therapies, nickel, plants
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12
Q

Gloved hands - why are the back of the hands normally more affected in contact dermatitis?

A

Skin on the back of the hand is thinner so allergen can penetrate skin faster

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13
Q

Immunopathology of contact allergic dermatitis

A

> Langerhans cell in epidermis processes antigen

> Processed antigen is then presented to Th cells in dermis

> Sensitised Th cells migrate into lymphatics and then to regional nodes where antigen is amplified

> Specifically sensitised T cells proliferate and migrate to and infiltrate the skin
—> DERMATITIS

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14
Q

Diagnosing contact allergy

A

Patch testing.

  1. Batteries of allergens are placed in small wells
  2. Applied to back skin and left in place for 48 hours
  3. Reactions checked after 96 hours
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15
Q

IRRITANT contact dermatitis

A

> Another v common type.

> non specific physical irritation rather than a specific allergic reaction

soap, detergent, cleaning products, water, oil

> Can be difficult to distinguish from allergic contact dermatitis and may CO EXIST

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16
Q

Nappy rash

A

Irritatn contact dermatitis to urine

17
Q

Atopic eczema/dermatitis

A

Itch scratch cycle.

Ill defined erythema and scaling

Generalised dry skin

Flexural distribution

Associated w/asthma, allergic rhinitis, food allergy

At flexures

Some fissuring

18
Q

What is pathognomonic of atopic eczema?

A

Scaling/dry skin at the ears.
Behind the ears/ at “flexure”.

Very characteristic

Does your child cry when you pull his top off? (Hitting his ears)

19
Q

Atopic eczema chronic changes

A

> Lichenification
Excoriation (erosion caused by scratching)
Secondary infection

20
Q

What does crusting indicate in atopic eczema?

A

Staph aureus infection.

21
Q

Eczema herpeticum

A

Herpes simplex virus

MONOMORPHIC PUNCHED OUT LESIONS

Child is systemically unwell.

IV antivirals
Fluid resus.

22
Q

Atopic eczema - diagnostic criteria

A

Itching +

visible flexural rash
hx of flexural rash
personal history of atopy
Generally dry skin
Onset before age 2 years
23
Q

In infants, what other sites can be affected by atopic eczema?

A

Cheeks and extensor surfaces

24
Q

Eczema - treatment

A

1) Emollients
2) Avoid irritants including shower gels and soaps
3) Topical steroids
4) Treat infection
5) Phototherapy (UVB)
6) Systemic immunosuppressants
7) Biologic agents

25
Q

Most important gene in atopic eczema?

A

Filaggrin

26
Q

Discoid Eczema

A

Very well defined lesions

Disc shaped.

Scratchingis inducing

27
Q

Photosensitive eczema

A

Chronic actinic dermatitis

(cut off at collar is normally a big clue)

Often atopic patients

28
Q

Other cause of photosensitive eczema?

A

Secondary to photosensitising drugs

29
Q

Stasis eczema

A

Secondary to:

Hydrostatic pressure
Oedema
Red cell extravasation

30
Q

Seborrhoeic dermatitis

A

Cradle cap in babies

Nasolabial folds in adults/ adolescents

31
Q

Pompholyx eczema

A

Spongiotic vesicles

Vesicles are intensely itchy

32
Q

Lichen simplex

A

Scratching

A pruritic eczematous condition resulting from continued rubbing and scratching at a localised area of the skin

assoiciated with a period of anxiety.

Signs
- solitary unilateral plaque
- fresh coloured pink, hyper pigmented 
lichenified surface 
well defined shape