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Dermatology > Dermatitis/ atopic ecema > Flashcards

Dermatitis/ atopic ecema Flashcards

1
Q

What will be seen histologically in eczema?

A

Spongiosis (oedema between keratinocytes)

Inflammatory cell infiltrate (acute or chronic lypphocytes and/ or neutrophils

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2
Q

What can be seen in the acute phase of eczema?

A 
Papulovesicular rash 
Erythematous lesions 
Oedema
Ooze/ scaling and crusting 
ITCH
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3
Q

What can be seen in the chronic phase of eczema?

A

Lichenification
Elevated plaques
Increased scaling
ITCH

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4
Q

What are the different types of dermatits?

A 
Contact allergic
Contact irritant
Atopic
Drug-related
Photo-induces or photosensitive
Lichen simplex
Stasis dermatitis
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5
Q

What can be seen in the histology of all dermatitis?

A

Spongiosis

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6
Q

What can be seen in the histology of drug related dermatitis?

A

Spoongiosis and eosinophils

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7
Q

What can be seen in the histology of stasis dermatitis?

A

Spongiosis and extravasation of RBCs

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8
Q

What is contact allergic dermatitis?

A

In response to chemicals, topical therapies, nickel and plants

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9
Q

What is the immunopathology of contact alllergic dermatitis?

A

Antigen of skin that passes through the skin surface to be detected by langerhan cells which will then migrate through the lymph to present to naeive T cells
These T cells are now primed and so next time the allergen is present, there will be an amplified response

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10
Q

What is irritant dermatitis?

A

Non-specific physical irritation rather than a specific allergic reaction
Can be difficult to distinguish from allergic contact dermatitis

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11
Q

What features can be seen in irritant dermatitis?

A

Erythema, scaling, fissuring, lichenification, nail dystrophy, crusting, erosions

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12
Q

How can atopic eczema be described?

A 
Prutitus
Ill-defined erythema and scaling 
Generalised dry skin 
Flexural distribution (varies with age) 
Associated with other atopic diseases: asthma, allergic rhinitis, food allergy
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13
Q

Where is atopic eczema likely to affect on the body?

A 
Knees
Ankles 
Eyes
Neck
Wrist 
Elbows 
Groin area
Flexural areas
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14
Q

What does a fissure beneath the ear lobe point to?

A

Pathognomic of atopic eczema

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15
Q

How will eczema present differently in POC?

A

Often a papular appearance, often with erythema and scaling but this can be hard to see

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16
Q

What would a papular rash in a caucasion person suggest?

A

Lichen planus

17
Q

What are chronic changes in atopic eczema?

A

Lichenification
Excoriation
Secondary infection

18
Q

What bacteria is likely to infect eczema?

A

Staph aureus - likely to produce a golden crust

19
Q

What is eczema herpeticum?

A

Herpes simplex virus that spreads all over eczema skin

20
Q

What does the eczema herpeticum rash look like?

A

Monomorphic punched-out lesions

21
Q

How can you treat eczema herpeticum?

A

Acyclovir

22
Q

What is the diagnostic criterea for atopic eczema?

A

Itching plus 3 or more: visible flexural rash, history of flexural rash, personal history of atopy, generally dry skin, onset before age 2

23
Q

How is eczema treated?

A

Plenty of emollients
Avoid irritants including shower gels and soaps
Topical steroids
Treat infection
Phototherapy - mainly UVB
Systemic immunosuppressants - cyclosporin, methotrexate or azathioprine

24
Q

What is the most important gene in control of the skin barrier?

A

Filaggrin

25
Q

What is discoid eczema?

A

Circular, well demarcated lesions of scaly, erythematous skin

26
Q

What is stasis eczema usually secondary to?

A

Hydrostatic pressure
Oedema
Red cell extravasation

27
Q

Where is stasis eczema most likely to occur?

A

Often occurs around the lateral malleolus as this is an area on the leg of greatest hydrostatic pressure

28
Q

What are the symptoms of seborrhoeic dermatitis?

A

Symptoms include red, scaly, greasy, itchy, and inflamed skin

29
Q

Where does seborrhoeic dermatitis usually occur?

A

Areas of the skin rich in oil-producing glands are often affected including the scalp, face, and chest

30
Q

What is pompholyx eczema?

A

Spongiotic vesicles that occur usually due to an acute eruption of eczema
Characteristially on the lateral aspects of the digits

31
Q

What causes lichen simplex?

A

Pathology is scratching

32
Q

How is lichen simplex treated?

A

Potent topical steroids

Dermatology (24 decks)

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