Dermatitis

Question 1

What is dermatitis?

Answer 1

Dermatitis is an umbrella term for a range of inflammatory skin conditions of varying aetiology.

Question 2

What are different types of eczema?

Answer 2

Endogenous
	• Atopic
	• Seborrhoeic 
	• Discoid
	• Varicose
	• Pompholyx 

Exogenous
• Contact (allergic, irritant)
• Photoreaction (allergic, drug).

Question 3

What is atopic eczema?

Answer 3

Itchy inflammatory skin condition associated with asthma, allergic rhinitis, conjunctivitis.

usually occurs in infants and children, with strong family history

Question 4

What areas are affected in atopic eczema?

Answer 4

Face, flexures,

Question 5

How is atopic eczema diagnosed?

Answer 5

Clinical (itchy skin with dry skin, atopy, visible flexural dermatitis)

IgE high

Allergy testing is useful

Question 6

What are complications of atopic eczema?

Answer 6

Infections

growth retardation

tiredness

Question 7

What is Rx of eczema?

Answer 7

Emollients (lots of)

Topical corticosteroids in exacerbations

Antihistamines may help

Severe disease may need immunosuppression, biologics UV therapy etc.

Question 8

What is contact dermatitis?

Answer 8

Contact dermatitis is an allergic or irritant skin reaction caused by an external agent.

Question 9

What are the 2 types of contact dermatitis?

Answer 9

Allergic: type IV hypersensitivity reaction caused by skin contact with certain trigger.
e.g. nickel, cobalt, fragrance.

Irritant:caused by a direct noxious effect on skin barrier e.g. soaps, detergents.

Question 10

What should you ask about in history for contact dermatitis?

Answer 10

• Look at employment, holidays, painting/metalwork, cosmetics, jewellery… all of which can be triggers
  
  • Pattern of rash: bilateral around earrings, hair dye, leather shoes, rubber gloves…
  • Commonly affects sun-exposed areas

Question 11

What Ix for contact dermatitis?

Answer 11

Patch test for reaction.

Otherwise clinical diagnosis

Question 12

What is Rx for contact dermatitis?

Answer 12

Avoid precipitants

Irritant: moisturiser and topical steroids

allergic: topical tacrolimus, phototherapy, immunsuppression if severe

Question 13

What is seborrhoeic dermatitis?

Answer 13

common inflammatory skin disorder that usually manifests as erythema and scaling of the scalp, nasolabial folds, glabella, and central face/anterior chest.

Caused by Overgrowth of Pityrosporum ovale yeast

Question 14

What areas are affected in seborrhoeic dermatitis?

Answer 14

Face, scalp, eyebrows, chest

Question 15

What are risk factors for seborrhoeic dermatitis?

Answer 15

• Stress
  
  • Parkinsonism
  • HIV
  • Age < 3 months

Question 16

What is Rx of seborrhoeic dermatitis?

Answer 16

Scalp
• Medicated anti-yeast shampoo
• Ketoconazole, coal tar

Face
	• Anti-microbial, mild steroid
		○ Daktocort cream
	• Simple moisturiser/emollient 
	• Topical tacrolimus 

Rarely
• Systemic antifungals e.g. itraconazole

Question 17

What is venous dermatitis?

Answer 17

Dermatitis overlying ares of chronic venous insufficiency.

Question 18

How is venous dermatitis treated/

Answer 18

• Emollients
  
  • Mild/moderate topical steroid
  • Compression bandaging/stockings
  • Consider early venous surgical intervention (see venous ulcers)