Dermatitis and Eczema Flashcards

1
Q

contact dermatitis

A

acute or chronic inflammatory reaction to substance that comes in contact with the skin

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2
Q

irritant contact dermatitis (ICD)

A

chemical irritant, can occur in anyone, confined to areas of exposure, certain threshold above which dermatitis occurs and below which it does not

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3
Q

allergic contact dermatitis (ACD)

A

type IV hypersensitivity reaction to an allergen, spreading reaction, occurs only in sensitized individuals

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4
Q

symptoms of acute ICD

A

burning, stinging, smarting (immediate - acid, chloroform, methanol), can start 1 -2 min, peak at 10 and fade after 30 min (delayed - propylene glycol)

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5
Q

presentation of acute ICD

A

well-demarcated erythema - vesicles and blisters - crusting - erosions, necrosis. NO papules.

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6
Q

symptoms of chronic ICD

A

stinging, smarting, burning AND itching - pain later

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7
Q

presentation of chronic ICD

A

dryness, chapping, erythema - hyperkeratosis and fissuring - lichenification, ill defined borders, crusting

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8
Q

treatment for acute ICD

A

remove offending agent, wet dressings with Burow’s solution q 2-3 h, topical glucocorticoids; 60mg red for 2 weeks with 10 mg taper

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9
Q

treatment for chronic ICD

A

remove offending agent, betamthasone or clobetasol; topical calcineurin inhibitors not enough to suppress inflammation

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10
Q

phytodermatitis - common offending agents

A

poison ivy, poison oak - oleoresins called uroshiol

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11
Q

derm path: ACD

A

spongiosis, lymphocytes and eosinophils, chronic - lichenification

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12
Q

Atopic dermatitis presentation

A

pruritus and itching leading to more inflammation and pruritus, lichenification: “itch scratch cycle”

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13
Q

AD microbial agents

A

Staph areus exotoxins, S. pyogenes

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14
Q

Skin barrier disruption of AD

A

defect in filaggrin, decreased ceramides

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15
Q

other atopies associated with AD

A

allergic rhinitis, asthma

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16
Q

pathophysiology of AD

A

type 1 HS reaction mediated by IgE as a result of vasoactive substances released by mast cells and basophils

17
Q

what type of AD is common in black people?

A

follicular lichenification

18
Q

pathogenesis of lichen simplex chronicus (LSC)

A

hyper excitability of lichenified skin in response to minimal external stimuli

19
Q

symptoms LSC

A

pruritus in paroxysms

20
Q

clinical presentation LSC

A

solid lichenified plaque with confluence of small papules. exoriations. dull red and later brown or black hyperpigmentation

21
Q

path LSC

A

hyperplasia of all epidermal components: hyperkeratosis, acanthosis, elongated and board rate ridges. chronic inflammatory infiltrate in the dermis

22
Q

mgmt LSC

A

occlusive bandages at night, topical glucocorticoid prep or tar prep covered by occlusive dressings for legs/arms, Unna boot: gauze roll dressing impregenated with zinc oxide paste wrapped around a large lichenified calf - left for one wee.

23
Q

Prurigo nodularis

A

associated with AD but occurs without it; starts with piercing pruritus leading to picking and scratching. Multiple, firm, dome shaped nodules with excoriations

24
Q

Tx prurigo nodularis

A

IL triamcinolone with occlusive dressings; neuron tin 300mg may be helpful

25
Dyshidrotic eczema
vesicular type of hand and foot dermatitis; sudden onset of deep-seated pruritic clear "tapioca-like" vesicles.
26
Nummular Eczema
pruritic coin-shaped plaques composed of papules or vesicles on an erythematous base, esp common in the winter months
27
Nummular eczema tx
hydrate with moisturizer or cream topical GC or 2-5% crude coal tar ointment
28
Autosensitization dermatitis or "id reaction"
generalized pruritic dermatitis directly related to primary dermatitis elsewhere. Primary releases cytokines into blood, heightening the sensitivity of distant skin areas.
29
2 diseases related to increased incidence of seborrheic dermatitis
PD and HIV
30
clinical presentations seborrheic dermatitis
greasy, erythema, yellow-orange scales and crusts on the scalp eyebrows, and beard
31
etiology seborrheic dermatitis
malesszia furfur - tx with ketoconazole or selenium sulfide
32
mineral deficiency that are seborrheic dermatitis-like
zinc (acrodermatitis enteropathica -perioral, diaper area at 6 month old), niacin, pyridoxine deficiency
33
asteatotic dermatitis
common pruritic dermatitis occurs esp in older persons in the winter in temperate climates; dry, "cracked" superficially fissured skin with slight scaling
34
mgmt asteatotic dermatitis
acid hot soapy baths and increasing ambient humidity to >50% with humidifiers