Dermatology 1: Eczema/dermatitis Flashcards
what is atopic eczema
-A group of conditions including asthma, eczema and hay fever.
-Atopic means it is linked to an increased activity of the allergy component of the immune system.
-It is an episodic disease of flares and remissions, comes and goes
-more common in children
factors that can increase risk of eczema
-climate change
-pollution
-family history with atopic conditions
scientifically what causes eczema/dermatitis
-oily lipid barrier of the skin is reduced i(defect in skin barrier) in patients with this, causes dry skin
-causes allergens to penetrate into the system, causing inflammation
what are trigger factors of eczema
-materials such as wool/excessive washing
-hormones, teething, sleep deprivation
-food such as cows=’s milk, eggs
-allergens e.g. pollen, dust
questions to ask when diagnosing
-location
-first time?
-comes and goes?
-triggers/allergies?
-family history?
-taken anything for it?
symptoms of eczema
-dry, itchy and flaky
-redness or maroon for darker skin types
-changes in skin pigmentation
-tiredness and irritable=bility for patiens
where does eczema show in adults and children
adults: elbows, knees, neck, wrists
children: face, scalp and above
when to refer for eczema
-if current management strategy is not working
-adverse reaction (reaction caused by medication) to emollients
-infection
-psychological implicatioms
-severe cracks in the skin
-differential diangosis
differential diagnosis of eczema
-acne
-rosacea
-shingles
-Lupus
-contact dermatitis due to allergens or irritants
-ringworm
-psoriasis
how to assess eczema
-assess the severity of eczema, where it is clear, mild, moderate, severe, infected etc.
-assess psychological impact e.g. mood, sleep, effect on daily activities
eczema practical measures
-correct use of emollients
-NHS pre payment certificate to cover prescription costs
-recognise symptoms of infection e.g. deep fissures (cracks in the skin) etc.
-recognise early symptoms of a flare up
-avoid triggers
-do not scratch
-keep nails short
eczema first line treatment and counselling
emollients to hydrate and soothe the skin: Aveeno and cetraben
-apply frequently and liberally (several times a day) on damp skin along the like of hair growth
-DO NOT USE AQUOUS CREAM, can cause sensitization reactions due to added additives e.g. Sodium lauryl sulphate. can be used as a SOAP SUBSTITUTR
eczema second line of treatment and how to use
topical corticosteroids to reduce inflammation , itchiness, redness.
Ointments preferred to creams but creams are better tolerated.
-hydrocortisone 1% cream 15g max treatment of 7 days. 10 years+
-clobetasone 0.05% 15. 12 years+
Apply thinly once or twice a day to affected areas only. Fingertip units
what is contact dermatitis
-inflammation of the skin that occurs when in contact with a particular substance
what is an irritant and examples
a substance that directly damages the epidermis
-soaps/detergents
-perfume/cosmetics
-plants
what is an allergen and examples
substance that triggers the immune system to respond in a way that affects the skin
-metal jewllery (nickel)
-perfume/cosmetics
symptoms of contact dermatitis
-red
-itchy (dominant in allergic)
-burning/stinging (irritant)
-dry and cracked
