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Dermatology > Dermatitis + Atopic Eczema > Flashcards

Dermatitis + Atopic Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

Define hyperkeratosis

A

Hyperkeratosis = increased thickness of keratin layer

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2
Q

Define parakeratosis

A

Parakeratosis = persistence of nuclei in the keratin layer

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3
Q

Define acanthosis

A

Acanthosis = increased thickness of epidermis

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4
Q

Define papillomatosis

A

Papillomatosis = irregular epithelial thickening

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5
Q

Define spongiosis

A

Spongiosis = oedema between keratinocytes

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6
Q

Define inflammatory cell infiltrate

A

Inflammatory cell infiltrate = acute or chronic lymphocytes and/or neutrophils

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7
Q

Give seven types of dermatitis

A
  1. Contact allergic
  2. Contact irritant
  3. Atopic
  4. Drug-related
  5. Photo-induced or photosensitive
  6. Lichen simplex
  7. Stasis dermatitis
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8
Q

Contact allergic dermatitis

  • Pathogenesis?
  • Histology?
A

Delayed type 4 hypersensitivity reaction

Spongiotic dermatitis

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9
Q

Contact irritant dermatitis

  • Pathogenesis?
  • Histology?
A

Trauma e.g. soap, water

Spongiotic dermatitis

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10
Q

Atopic dermatitis

  • Pathogenesis
  • Histology?
A

Genetic + environmental factors resulting in inflammation

Spongiotic dermatitis

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11
Q

Drug-related dermatitis

  • Pathogenesis
  • Histology?
A

Type I or IV hypersensitivity reaction

Spongiotic dermatitis + eosinophils

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12
Q

Photo-induced or photosensitive dermatitis

  • Pathogenesis
  • Histology?
A

Reaction to UV light

Spongiotic dermatitis

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13
Q

Lichen simplex dermatitis

  • Pathogenesis
  • Histology?
A

Physical trauma to the skin e.g. scratching

Spongiotic dermatitis + external trauma

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14
Q

Stasis dermatitis

  • Pathogenesis
  • Histology?
A

Physical trauma to the skin - hydrostatic pressure

Spongiotic dermatitis + extravasation of RBCs

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15
Q

Define contact allergy

Specific or non-specific?

A

Contact allergy – something has to come into contact to the skin which develops a delayed type hypersensitivity reaction. This is SPECIFIC.

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16
Q

Define contact irritant

A

Contact irritant – non-specific reaction to something that is lightly traumatising the skin e.g. soap and water.

17
Q

How can drug related dermatitis be confirmed on histology?

A

Presence of eosinophils

18
Q

Contact allergic dermatitis

- Name some allergens

A

Very common in response to chemicals, topical therapies, nickel (most common), plants, latex, perfumes etc.

19
Q

What is irritant (contact) dermatitis?

- Name some common irritants

A

This is non-specific physical irritation rather than a specific allergic reaction.
E.g. soap/detergent/cleaning products, water, oil - may be difficult to distinguish from allergic contact dermatitis – e.g. using cleaning product with fragrance in it may be allergic irritant, or both.

20
Q

Give some common clinical features of atopic eczema

A
  • Pruritus
  • Ill-defined erythema & scaling
  • Generalised dry skin
  • Flexural distribution (varies with age)
  • Associated with other atopic diseases, e.g. asthma, allergic rhinitis, food allergy
21
Q

Give three chronic changes in atopic eczema.

What does crusting indicate?

A
  • Lichenification
  • Excoriation – means breaking of the skin surface by external trauma
  • Secondary infection – most commonly staph aureus in eczema
    Crusting indicates staph aureus infection.
22
Q

Monomorphic punched out lesions = ?

A

Eczema herpeticum casued by herpes simplex virus

23
Q

What are some treatment options for atopic eczema?

A
  1. Plenty of emollients*
  2. Avoid irritants including shower gels and soaps
  3. Topical steroids*
  4. Treat infection
  5. Phototherapy – mainly UVB
  6. Systemic immunosuppressants
  7. (Biologic agents)
24
Q

Discoid eczema

  • Symptoms?
  • Associated with?
A

Shows a well-defined erythema and scale.

These patients are often atopic too.

25
Q

Photosensitive eczema

  • Aka?
  • Where on body?
  • What else should you take into account?
A

Aka chronic actinic dermatitis – look for cut off at collar and cuffs.
Photosensitizing drugs should also be taken into account when dealing with photosensitive eczema.

26
Q

Stasis eczema

  • Caused by?
  • Aka?
A

Caused by atopic eczema and an inflammatory response to colonization on the skin.
Also called “cradle cap”, shown opposite.

Dermatology (17 decks)

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