Dermatology

Question 1

What is eczema

Answer 1

Papules and vesicles on an erythematous base

Question 2

What is the most common type of eczema

Answer 2

Atopic eczema

appears in early childhood

Question 3

What are the causes of eczema

Answer 3

positive family hx of atopy
Primary genetic defect in skin barrier function
Exacerbating factors - infections, allergens e.g. chemicals, food, dust, pet fur, sweating, heat and severe stress

Question 4

How does eczema present

Answer 4

Itchy, erythematous, dry, scaly patches
Usually on flexural surfaces e.g. antecubital fossa, popliteal fossa, neck and behind ears
Chronic scratching and rubbing –> excoriations and lichenification
Nail changes - pitting and ridging of nails

Question 5

How may acute eczema lesions present

Answer 5

Erythematous
vesicular
Weepy - exudate

Question 6

How is eczema managed

Answer 6

General - avoid known exacerbating agents, frequent emollients and soap substitute
Topical therapies - Topical steroids for flare ups, topical immunomodulators e.g. tacromilus
Oral therapies - antihistamines, abx for secondary bacterial infections
Antivirals e.g. aciclovir for secondary herpes infection
Phototherapy and immunosuppressants e.g prednisolone, azathioprine, ciclosporin