Dermatitis/Eczema Flashcards
Biopsy of skin with eczema?
Spongiosis- oedema between keratinocytes
Inflammatory cell infiltrate: acute or chronic lymphocytes and/or neutrophils
Acute phase of eczema?
Papulovesicular
Erthematous (red) lesions
Oedema (spongiosis)
Ooze or scaling & crusting
Chronic phase of eczema?
Thickening (lichenification)
Elevated plaques
Increased scaling
Contact allergic dermatitis is very common. True or false?
TRUE
Very common
In response: to chemicals, topical, therapies, nickel, plants
Immunopathology of contact allergic dermatitis?
Langerhans cell in epidermis processes antigen
Processed antigen is then presented to Th cells in dermis
Sensitized Th cells migrate into lymphatics and hen to regional nodes when antigen presentation is amplified
What is difficult to distinguish from allergic contact dermatitis?
Irritant dermatitis
5 clinical features of irritant dermatitis?
Erythema Scaling Fissuring Lichenification Nail dystrophy Crusting
What is nappy rash?
Irritant contact dermatitis to urine
With ulceration
Sparing of flexures
Characteristics of atopic eczema?
Pruritus Ill-defined erythema & scaling Generalized dry skin Flexural distribution Associated with other atopic diseases: asthma, allergic rhinitis, food allergy
Chronic changes atopic eczema?
Lichenification
Excoriation
Secondary infection
What does crusting of atopic eczema indicate?
Staph.aureus infection
What does eczema herpeticum?
Infection that needs to be recognised early
- HSV
- Monomorphic punched-out lesions
Diagnostic criteria for atopic eczema?
Itching + 3 more of
- Visible flexural rash
- History of flexural rash
- Personal history of atropy
- Generally dry skin
- Onset before age 2 years
Treatment of eczema?
- Plenty of emollients
- Avoid irritants, including shower gels/soaps
- Topical steroids
- Treat infections
- Phototherapy
- Systemic immunosuppressants
Other types/distributions of dermatitis/eczema?
Discoid eczema Photosensitive eczema Stasis eczema Seborrhoeic dermatitis Pompholyx eczema Lichen simplex
