Dermatitis / Eczema

Question 1

Dermatitis has two phases. What are they?

Answer 1

Acute phase (oozing, scaling, crusting) and chronic (lichenification, elevated plaques)

Question 2

What is the “key” symptom of eczema which makes other rashes unlikely to be eczema if they do not have this?

Answer 2

Itching

Question 3

Spongiotic oedema is histological buzz-word for…

Answer 3

Eczema

Question 4

Lichen simplex is a type of eczema. True/false?

Answer 4

True

Question 5

Name 7 types of eczema

Answer 5

1) Contact allergic 2) Contact irritant 3) Atopic 4) Drug related 5) Photosensitive 6) Lichen simplex 7) Stasis dermatitis

Question 6

What differentiates contact allergic from contact irritant dermatitis?

Answer 6

Allergic is a delayed type (IV) sensitivity while irritant is a reaction to trauma or immediate insult (e.g. harsh soap)

Question 7

Drug related eczema is what type(s) of hypersensitivity reaction? (2)

Answer 7

-Type I -Type IV

Question 8

Stasis dermatitis is caused by what

Answer 8

Raised hydrostatic pressure

Question 9

Most common causative agent of contact allergic dermatitis

Answer 9

Nickel (20% of Europeans allergic)

Question 10

What’s the gold standard diagnostic test for contact allergy?

Answer 10

Patch testing

Question 11

How long are patch tests applied for? When are they read?

Answer 11

Applied = 48 hours Read = 96 hours

Question 12

Irritant contact dermatitis is always specific. True/false?

Answer 12

False

Question 13

Nappy rash is a typical type of which dermatitis?

Answer 13

Irritant contact dermatitis

Question 14

Atopic eczema / atopic dermatitis affects which % of school-aged children?

Answer 14

25%

Question 15

Extensor/flexural distribution of eczema is the most common.

Answer 15

Flexural (crooks)

Question 16

S. aureus is common secondary infection in chronic eczema. True/false?

Answer 16

True

Question 17

Eczema herpeticum has what characteristic lesion pattern?

Answer 17

Monomorphic, punched out lesions

Question 18

Eczema herpeticum should be immediately treated with typical eczema therapies. True/false?

Answer 18

False - aciclovir should be included

Question 19

Itching + 3 or more of these are required to diagnose atopic eczema (5)

Answer 19

1) Visible flexural rash 2) History of flexural rash 3) Personal history or first-degree relative of atopy 4) Generally dry skin 5) Onset before 2yo.

Question 20

Describe the stepwise treatment of eczema (from initial management to late) (7)

Answer 20

1) Emollients 2) Avoid irritants 3) Topical steroids 4) Treatment of underlying infection 5) Phototherapy 6) Systemic immunosuppresants (e.g. cyclosporin) 7) Biologics

Question 21

The gene mutation strongly assoicated with eczema?

Answer 21

Filaggrin

Question 22

Difference between plaque psoriasis and discoid eczema? (2)

Answer 22

-Eczema flexural, psoriasis extensor -Discoid eczema tend to be flat, while psoriasis plaques raised

Question 23

RBC extravasation due to raised hydrostatic pressure may cause….

Answer 23

Stasis eczema

Question 24

Cradle cap is caused by an infection. True/false?

Answer 24

False - this is seborrheic dermatitis (caused by allergy affecting sebum glands)

Question 25

List the structures

Answer 25

A = Hyperkeratosis

B = Parakeratosis

C = Acanthosis

Question 26

Spot Diagnosis

Answer 26

Eczema Herpeticum

Question 27

Spot Diagnosis

Answer 27

Seborrhoeic Dermatitis