Dermatology Flashcards
define atopic dermatitis (eczema)
a common skin condition starting in childhood that causes dry skin and flares of erythematous, poorly demarcated itchy patches
areas commonly affected by eczema
in infants:
- cheeks of the face
- patches on the body
in older children:
- flexures (bends of elbow and behind knees)
NICE diagnostic criteria of eczema
itchy skin +3-5 of: visible flexural eczema history of flexural eczema history of dry skin history of asthma or allergic rhinitis onset < 2yrs
risk factors/triggers of eczema
irritants
abrasive fabrics
filaggrin protein deficiency
stress
management of eczema (step wise approach)
mild: hydrocortisone
moderate: eumovate
potent: betnovate
very potent: dermovate
additional management of eczema
avoiding use of soaps or potential irritants
use of emollients (e.g. ointments or creams)
side effects of topical corticosteroid use
skin thinning, striae and telangiectasia
eczema complication: eczema herpeticum
an infection due to disseminated HSV that occurs as a result of impaired skin protection
clinical features of eczema herpeticum
monomorphic vesicular rash that ulcerates and crusts
fever
diagnosis and management of eczema herpeticum
swab + Tzanck test
IV aciclovir
eczema complication: erythrodema
widespread erythema (>90% skin surface) due to exacerbation of eczema
define contact dermatitis
eczema that occurs following exposure to a causative agent
clinical features of contact dermatitis
dry rash commonly located on the hands asymmetrically that is: erythematous blistering painful pruritic fissured
types of contact dermatitis
irritant contact dermatitis
allergic contact dermatitis
define irritant contact dermatitis
follows repeated exposure to a metal, solvent or detergent
common in those with an underlying skin condition
presents with rash limited to area of contact
rash is painful and burns
define allergic contact dermatitis
occurs in those sensitised to allergens
rash is pruritic and extends beyond contact site
type of IV hypersensitivity reaction
management of contact dermatitis
emollient creams
topical corticosteroids
identify and avoid irritant or allergen
investigations of contact dermatitis
patch testing - range of allergens in separate patches on the skin
define infantile seborrhoeic dermatitis (cradle cap)
a skin condition in infants <3mnths that causes diffuse, yellow and greasy scales on the scalp, groin or armpit with NO erythema
management of infantile seborrhoeic dermatitis
topical emollient (e.g. olive oil) massaged into scalp
if symptoms persist:
topical antifungal
appearance of meningitis
rapidly developing non-blanching purpuric rash with: lethargy headache fever rigors vomiting
immediate management of meningitis
IM benzylpenicillin and hospital admission
appearance on slapped cheek syndrome (Parvovirus B19)
symmetrical erythematous rash on both cheeks with associated fever
additional reticular rash on trunk and limbs
appearance of hand, foot and mouth disease
blisters on the hands and feet
ulcers on the tongue
fever
