Dermatitis

Question 1

What is meant by hyperkeratosis?

Answer 1

Increased thickness of the keratin layer

Question 2

What is meant by parakeratosis?

Answer 2

Epidermal cell turnover occurs more frequently

Question 3

What is meant by acanthosis?

Answer 3

Increased thickness of epidermis

Question 4

What is meant by papillomatosis?

Answer 4

Irregular epithelial thickening

Question 5

What is meant by spongiosis?

Answer 5

Oedema between keratinocytes

Question 6

Dermatitis is synonymous with eczema. True/False?

Answer 6

True

Question 7

List some features of the acute phase of dermatitis

Answer 7

Red, erythematous lesions
Oedema
Ooze, scaling, crusting

Question 8

List some features of the chronic phase of dermatitis

Answer 8

Thickening (lichenification)
Elevated plaques
Scaling

Question 9

What symptom is always experienced with eczema?

Answer 9

Itch

Question 10

Name the 7 classifications of dermatitis

Answer 10

Contact allergic
Contact irritant
Atopic
Drug-induced
Photosensitive
Lichen simplex
Stasis dermatitis

Question 11

What is the basic pathogenesis behind contact allergic dermatitis?

Answer 11

Type 4 (delayed) hypersensitivity

Question 12

What is the basic pathogenesis behind lichen simplex dermatitis?

Answer 12

Physical trauma to skin, e.g. persistent scratching

Question 13

List some common causes of contact allergic dermatitis

Answer 13

Nickel
Latex
Topical therapies
Plants

Question 14

What causes “weeping” in eczema?

Answer 14

Oedema between keratocytes (spongiosis) spills out onto skin surface

Question 15

What investigation can be used to identify substances causing contact allergic dermatitis?

Answer 15

Patch testing

Question 16

What is involved in patch testing?

Answer 16

Wells containing allergen applied to skin on back and left for 48-96hrs

Question 17

Which dermatitis - contact allergic or irritant - is a non-specific reaction?

Answer 17

Contact irritant dermatitis

Question 18

List examples of things that cause contact irritant dermatitis

Answer 18

Soap
Detergent
Oil
Nappy rash

Question 19

Contact allergic and irritant dermatitis are easy to distinguish. True/False?

Answer 19

False

Often need to patch test

Question 20

List some symptoms and signs of atopic eczema/ dermatitis

Answer 20

Pruritis
Scaling
Poorly defined erythema
Dry skin
Flexural distribution

Question 21

Atopic dermatitis is associated with other atopic diseases. True/False?
Give some examples

Answer 21

True

Asthma, food allergy, allergic rhinitis

Question 22

Secondary infection of atopic eczema is common and occurs due to which organism?

Answer 22

Staph aureus

Question 23

Which virus causes eczema herpeticum?

Answer 23

Herpes simplex virus

Question 24

What does eczema herpeticum look like? (buzzword!)

Answer 24

Monomorphic, punched-out lesions

Question 25

What is the UK diagnostic criteria for atopic eczema?

Answer 25

Itch + at least 3 of:
Flexural rash
History of atopy
Dry skin
Onset before the age of 2

Question 26

List step up therapy for eczema

Answer 26

Emollients + topical steroid;
if infection add antibiotics/antiviral;
phototherapy;
immunosuppressants if systemic upset

Question 27

What is another name for photosensitive dermatitis? What is a classical sign?

Answer 27

Chronic actinic dermatitis

Cut-off at collar

Question 28

What name describes the sudden onset of acute eczema?

Answer 28

Pompholyx eczema