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Dermatology > Dermatitis/ Eczema > Flashcards

Dermatitis/ Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

What is parakeratosis?

A

Persistence of nuclei in the keratin later

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2
Q

What is acanthosis?

A

Thickened epidermis…

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3
Q

What is papillomatosis?

A

Irregular epithelial thickening

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4
Q

What is spongiosis?

A

Oedema between keratinocytes

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5
Q

What occurs in the acute phase of eczema?

A

Papulovesicular, red lesions, oedema (spongiosis), ooze or scarring and crusting

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6
Q

What occurs in the chronic phase of eczema?

A

Thickening (lichenification), elevated plaques, increased scaling

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7
Q

What are the causes of contact allergic dermatitis?

A

Response to chemicals, topical therapies, …

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8
Q

What is hyperkeratosis?

A

Increased thickness of keratin layer

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9
Q

What is the immunopathology of contact allergic dermatitis?

A

Langerhans in epidermis processes antigen (increased immunogenicity). Processed antigen is then presented to Th cells in dermis. Sensitized Th cells migrate into lymphatics, then to regional nodes where Ag presentation is amplified. Subsequent challenge- specific T cells proliferate/migrate to skin, results in dermatitis

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10
Q

How can specific substances causing contact dermatitis be identified?

A

Patch testing

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11
Q

What is irritant dermatitis?

A

Non specific physical irritation rather than specific allergic reaction

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12
Q

What is nappy rash?

A

Irritant contact dermatitis to urine with ulceration

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13
Q

What symptom occurs in atopic eczema which leads to neurocognitive impairment?

A

Pruritis> sleep disturbance> neurocognitive impairment

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14
Q

What symptoms are associated with atopic eczema?

A

Pruritis, ill-defined erythema & scaling, generalized dry skin, flexural distribution (varies with age). Associated with other atopic diseases

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15
Q

What chronic changes occur in atopic eczema?

A

Lichenification, excoriation, 2’ infection

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16
Q

What bacteria does crusting in atopic eczema indicate?

A

S. aureus

17
Q

What virus causes eczema herpeticum with infection, and what is it characterized by?

A

HSV, monomorphic punched out lesions

18
Q

What is the UK diagnostic criteria for atopic eczema?

A

Itching plus 3 or more of: visible flexural rash, history of flexural rash, personal history of atopy (or 1’ relative if

19
Q

What is the treatment of eczema?

A 
Plenty of emollients
Avoid irritants including shower gels and soaps
Topical steroids
Treat infection
Phototherapy – mainly UVB
Systemic immunosuppressants
(Biologic agents)
20
Q

What is the most important gene in the factors that cause atopic eczema?

A

Filaggrin

21
Q

If you see a dermatitis cut off at collar, what is it likely to be?

A

Photosensitive eczema/chronic actinic dermatitis, or caused by photosensitizing drugs

22
Q

What is stasis eczema secondary to?

A

Hydrostatic pressure, oedema, red cell extravasation

23
Q

What symptom will you commonly see in pompholyx eczema, and often where?

A

Spongiotic vesicles- often side of fingers

24
Q

Describe the lesions and locations in psoriasis

A

Symmetrical, sharply demarcated, scaly, erythematous plaques. Extensors, scalp, sacrum, hands, feet, trunk, nails

25
Q

Where is acne vulgaris distributed?

A

Sites with most sebaceous glands- face, upper back, anterior chest

26
Q

What morphology is noted with acne vulgaris?

A

Comedones- open (blackhead) and closed (whitehead), pustules, papules, cysts

27
Q

What secondary features are present in acne vulgaris?

A

Scars- atrophic, ice-pick, texture changes, hypertrophic

28
Q

What are the 3 grades of acne, and how are they defined?

A

Mild- scattered papules and pustules, comedones

Moderate - numerous papules, pustules &
mild atrophic scarring

Severe - as above, cysts, nodules and significant scarring

29
Q

What is found in rosacea?

A

Papules, pustules and erythema with no comedones, prominent facial flushing exacerbated by sudden change in temperature , alcohol & spicy food

30
Q

What is the Nikolsky sign?

A

Nikolsky sign is a skin finding in which the top layers of the skin slip away from the lower layers when slightly rubbed

31
Q

When is the Nikolsky sign +ve and -ve?

A

+ve in pemphigus vulgaris, -ve in bullous pemphigoid

32
Q

What investigations are required in pemphigus and pemphigoid?

A

Skin biopsy with direct immunofluorescence, indirect immunofluorescence

33
Q

What is the treatment of pemphigoid and pemphigus?

A

Systemic steroids
Other immunosuppressive agents: azathioprine, ciclosporin, mycophenolate
In pemphigoid: tetracycline antibiotics, nicotinamide
Topicals: emollients, topical steroids

Dermatology (14 decks)

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