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Dermatology > Dermatitis/Eczema > Flashcards

Dermatitis/Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

What is Hyperkeratosis?

A

Increased thickness of keratin layer

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2
Q

What is Parakeratosis?

A

Persistence of nuclei in the keratin layer

these would usually be lost in the cornification process in the granular layer

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3
Q

What is Acanthosis?

A

Increased thickness of epidermis

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4
Q

What two things can be seen histologically in a skin biopsy with eczema?

A

Inflammatory cell infiltrate

Spongiosis

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5
Q

What is spongiosis?

A

Oedema between keratinocytes

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6
Q

What are inflammatory cell infiltrates?

A

Acute or chronic

lymphocytes and/or neutrophils

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7
Q

Describe the morphology of the acute phase of eczema

A

papulovesicular
erthematous (red) lesions
oedema (spongiosis)
ooze or scaling and crusting

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8
Q

Describe the morphology of the chronic phase of eczema

A

thickening (lichenification)
elevated plaques
Increased scaling

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9
Q

`What 4 concepts are the best descriptors of eczema?

A

Itchy
ill-defined
erythematous
scaly

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10
Q

Describe the pathogenesis and histological appearance of a Contact Allergic Dermatitis

A

PATHOGENESIS: Type IV delayed hypersensitivity reaction

HISTOLOGY: spongiotic dermatitis

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11
Q

Describe the pathogenesis and histological appearance of a Contact Irritant Dermatitis

A

PATHOGENESIS: Trauma e.g. Soap/water

HISTOLOGY: spongiotic dermatitis

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12
Q

Describe the pathogenesis and histological appearance of Atopic eczema

A

PATHOGENESIS: Genetic and Environmental factors = inflammation

HISTOLOGY: spongiotic dermatitis

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13
Q

Describe the pathogenesis and histological appearance of Drug related eczema

A

PATHOGENESIS: Type I and Type IV Hypersensitivity Reaction

HISTOLOGY: Spongiotic dermatitis and Eosinophils

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14
Q

Describe the pathogenesis and histological appearance of photo-induced/photosensitive eczema

A

PATHOGENESIS: Reaction to UV light

HISTOLOGY: spongiotic dermatitis

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15
Q

Describe the pathogenesis and histological appearance of Lichen Simplex

A

PATHOGENESIS: Physical Trauma to skin e.g. scratching

HISTOLOGY: spongiotic dermatitis and external trauma

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16
Q

Describe the pathogenesis and histological appearance of Stasis Dermatitis

A

PATHOGENESIS: Physical Trauma to skin e.g. hydrostatic pressure

HISTOLOGY: spongiotic dermatitis and extravasation of RBC’s

17
Q

What are the most common causes of contact allergic dermatitis?

A

chemicals
topical therapies
NICKEL
plants

18
Q

Describe the process of patch testing for a specific allergen

A

Batteries of allergens are placed in small wells
Applied to back skin
Left in place for 48 hours
Reactions checked at 96 hours

19
Q

What is a contact irritant dermatitis?

A

Non-specific physical irritation rather than a specific allergic reaction

Eg Soap/detergent/cleaning products, water, oil

20
Q

Name clinical features which are often seen in hand dermatitis

A 
Erythema
scaling
fissuring
lichenification
nail dystrophy
crusting
21
Q

What type of dermatitis is Nappy Rash?

A

irritant contact dermatitis to urine

sometimes with ulceration

NOTE: sparing of flexures - unlike in fungal infection

22
Q

What percentage of school children are affected by atopic eczema?

A

25%

23
Q

How can pruritus in atopic eczema affect children of school age?

A

Leads to sleep disturbance and therefore neurocognitive impairment at school

24
Q

Describe the typical distribution seen in atopic eczema

A

Flexural distribution

(inside elbow, back of knee, inside of wrists, front of ankles)

sometimes eyes/neck/genital areas

25
Q

What other atopic diseases are often associated with eczema?

A

hayfever
asthma
food allergy

26
Q

Describe the appearance of atopic eczema in skin of colour

A

papular
ill defined erythema (often difficult to see)
scaling
extensive lichenification and keloid scarring

27
Q

What secondary infection is common in atopic eczema

A

staph aureus
gold crusting
(this easily multiplies on eczema prone skin)

28
Q

What variation of eczema presents as monomorphic punched out lesions and what virus is it caused by?

A

Eczema Herpeticum

Caused by Herpes Simplex

29
Q

What is the diagnostic criteria for atopic eczema in the UK?

A

Itching plus 3 or more:

  • Visible (or Hx of) flexural rash
  • Personal history of atopy (or 1st degree relative if under 4)
  • Generally dry skin
  • Onset before age 2 years
30
Q

Describe the progression of treatments for eczema

A
  • Plenty of emollients
  • Avoid irritants including shower gels and soaps
  • Topical steroids
  • Treat infection
  • Phototherapy – mainly UVB
  • Systemic immunosuppressants
  • Biologic agents
31
Q

How does discoid eczema usually present?

A

Well defined discrete lesions
Patient can often be atopic too
Also can cause secondary infection

32
Q

How is photosensitive eczema usually noticed?

A

Cut off at collar

also known as Chronic Actinic Dermatitis

33
Q

Where does stasis eczema usually present?

A

The lateral malleolus

34
Q

What is another word for seborrhoeic dermatitis?

A

Cradle Cap

35
Q

What is seborrhoeic dermatitis usually accompanied by?

A

Fungal infection

36
Q

What is typical of Pompholyx Eczema?

A

Sudden onset of Spongiotic vesicles

On lateral aspect of the digits

Dermatology (18 decks)

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