Dermatitis / Eczema Flashcards
Dermatitis has two phases. What are they?
Acute phase (oozing, scaling, crusting) and chronic (lichenification, elevated plaques)
What is the “key” symptom of eczema which makes other rashes unlikely to be eczema if they do not have this?
Itching
Spongiotic oedema is histological buzz-word for…
Eczema
Lichen simplex is a type of eczema. True/false?
True
Name 7 types of eczema
1) Contact allergic 2) Contact irritant 3) Atopic 4) Drug related 5) Photosensitive 6) Lichen simplex 7) Stasis dermatitis
What differentiates contact allergic from contact irritant dermatitis?
Allergic is a delayed type (IV) sensitivity while irritant is a reaction to trauma or immediate insult (e.g. harsh soap)
Drug related eczema is what type(s) of hypersensitivity reaction? (2)
-Type I -Type IV
Stasis dermatitis is caused by what
Raised hydrostatic pressure
Most common causative agent of contact allergic dermatitis
Nickel (20% of Europeans allergic)
What’s the gold standard diagnostic test for contact allergy?
Patch testing
How long are patch tests applied for? When are they read?
Applied = 48 hours Read = 96 hours
Irritant contact dermatitis is always specific. True/false?
False
Nappy rash is a typical type of which dermatitis?
Irritant contact dermatitis
Atopic eczema / atopic dermatitis affects which % of school-aged children?
25%
Extensor/flexural distribution of eczema is the most common.
Flexural (crooks)
S. aureus is common secondary infection in chronic eczema. True/false?
True
Eczema herpeticum has what characteristic lesion pattern?
Monomorphic, punched out lesions
Eczema herpeticum should be immediately treated with typical eczema therapies. True/false?
False - aciclovir should be included
Itching + 3 or more of these are required to diagnose atopic eczema (5)
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.
Describe the stepwise treatment of eczema (from initial management to late) (7)
1) Emollients 2) Avoid irritants 3) Topical steroids 4) Treatment of underlying infection 5) Phototherapy 6) Systemic immunosuppresants (e.g. cyclosporin) 7) Biologics
The gene mutation strongly assoicated with eczema?
Filaggrin
Difference between plaque psoriasis and discoid eczema? (2)
-Eczema flexural, psoriasis extensor -Discoid eczema tend to be flat, while psoriasis plaques raised
RBC extravasation due to raised hydrostatic pressure may cause….
Stasis eczema
Cradle cap is caused by an infection. True/false?
False - this is seborrheic dermatitis (caused by allergy affecting sebum glands)
