Dermatitis & Eczema Flashcards
What is Parakeratosis?
Skin cells turnover quickly, nuclei not removed from keratin layer
What is Acanthosis?
Increased thickness of the epidermis
What is Hyperkeratosis?
Increased thickness of keratin layer
What is Papillomatosis?
Irregular epithelial thickening
What is Spongiosis?
Intracellular oedema between keratinocytes. Water that has leaked out of the cells
What is the classic rash presentation for eczema?
Itchy, ill-defined, eythemtous and scaly
What is the most common type of dermatitis?
Contact allergic dermatitis
What immunological cell causes the reaction of contact allergic dermatitis?
Langerhans cells
What is the difference between contact allergic dermatitis and irritant contact dermatitis?
and what test should you do to differentiate?
Allergic is hypersensitivity 1 => IgE mediated
Irritant is a non-specific physical irritation
Skin allergen test
What is Naptkin Dermatitis
Nappy rash - an allergic reaction to urine and faeces
NOTE
that is spares the flexures
What other atopic disease is associated with eczema?
asthma
allergic rhinitis
food allergy
hayfever
Where are common places to be affected by eczema?
Flexures –> knee, elbow, wrists
Eyes
Neck
Genital area
What are the chronic changes of eczema?
Lichenification
Excoriation
Secondary infection
What does crusting of eczema indicate?
Secondary infection –> s. aureus
What virus causes Eczema Herpeticum?
Herpes simplex virus
What infection gives the signature monomorphic punched out lesions?
Eczema Herpeticum
What is the criteria in the UK for diagnosing atopic eczema?
Itching plus 3 or more:
visible flexure rash
history of flexure rash
personal history of atopy (or first degree relative if
What are the treatments for atopic eczema?
Emollients Avoid irritants including showers gels and soaps Topical steroids Treat infection Phototherapy - mainly UVB Systemic immunosuppressants (Biological agents)
What is the most important gene to consider in atopic eczema?
Filaggrin
What is discoid eczema?
Eczema in the form of a disc shaped rash
What is photosensitive eczema?
Also known as CHRONIC ACTINIC DERMATITIS
Sun cause eczema rash
Will have sharp cut off where clothing covers the skin
A patient comes in the suspected photosensitive eczema, but their rash does not have a cut off point despite being covered in clothing, what could the other diagnosis be?
Photosensitivity secondary to photosensitising drugs
What causes stasis eczema?
Occurring due to physical trauma of increased hydrostatic eczema
How is stasis eczema treated?
Bandaging or surgical intervention. Need to treat underlying cause
What is stasis eczema secondary to?
Hydrostatic pressure
Oedema
Red cell extravasation
What is Seborrhaoeic Dermatitis and who does it occur in?
Cradle cap and it occurs in young children and infants due to excessive production of sebum
Treatment for Sebrrhaoeic Dermatitis?
Will clear on it own. Wash babies head, massage in oils etc.
What is Pompholyx eczema?
Pompholyx is a type of eczema that causes tiny blisters to develop across the fingers, palms of the hands and sometimes the soles of the feet. It’s also known as dyshidrotic eczema.
Any acute eczema can cause ponphlolyx
Where does lichen planus commonly present?
arms, legs and trunk
mouth (oral lichen planus)
nails and scalp
vulva, vagina and penis
Where are melanocytes found?
Dermo-epidermal junction
What is the dermis composed of?
type I and type II collagen and formed by elastic fibres –> basically connective tissue
What are the 4 reaction patterns in the classification of inflammatory skin disease?
i) Spongiotic -intraepidermal oedema
ii) Psoriasiform-elongation of the rete edges
iii) Lichenoid-basal layer damage
iv) Vesiculobullous-blistering
Example of Spongiotic -intraepidermal oedema?
Eczema
Example of Psoriasiform-elongation of the rete edges?
Psoriasis
Example of Lichenoid-basal layer damage?
Lichen planus
Lupus Erythematosus
Example of Vesiculobullous-blistering ?
Pemphigoid
Pemphigus
Dermatitis Herpetiformis
In what two pathologies of the skin would you see Neutrophils in the corneal layer?
Fungal infections
Psoriasis