Dermatology Flashcards
What is Eczema/Dermatitis
Itchy, Dry inflammatory Skin disease
How is Eczema Classified
Endogenous - Atopic, Seborrheic, Discoid, Pomphlyx, Varicose
Exogenous: Allergic Contact, Irritant Contact, Photosensitive
What can Cause A childhood Flare of eczema
Infections Environment: Aircon, Central Heating, Pets: Contact and Sensitisation Stress such as teething Often No cause
Features of Atopic Eczema
Most common - ! of the 3 atopies
Family Link
in infancy - Starts at face(cheeks) and the neck
Older Children - Flexural Pattern
What causes Atopic Eczema
Abnormalities in Fillagrin expression resulting in a skin barrier defect
Decreased keratin bonding and decreased moisture.
this loss of the barrier allow irritants to penetrate
Features of Seborrheic Eczema
Prominent on scalp and face - scaly dry patchy skin
commonly <3months, clears by 12.
Treatment of Seborrheic Eczema
Emollients
Antifungal Creams/Shampoos
Mild Topical Steroid - Hydrocortisone
Signs that may lead you to suspect a food allergy`
Instant reaction - Lip Swelling, facial redness/itch, anaphylactoid symptoms
Late reactions may occur - 24/48 hours later
Gi Problems
Failure to thrive
Severe eczema unresponsive to treatment
severe generalised itch even in skin is clear
2 ways of testing food allergies
Bloods - IgE reaction to certain foods
Skin Patch Testing
Other Allergies tested in the same way
Treatment for Eczema
Emollients - Fragrance free, the greasier the better
Topical Steroids: use appropriately to avoid skin tinning
Mild: hydrocortisone
Mod: Eumovate
Potent: Bontovate
V. Potent: Dermovate
UBV Light therapy
immunosuppression
Calcineurate inhibitors
Correct use of Steroids
Used OD for 1-2 weeks
Improvement: Every second day for a few days
Stubborn/Persistent: 2x a day it these areas.
Features of Impetigo
Subacute Staph A. infection
Honey coloured, Crusted papules and erosion on the face around the mouth
Rx of Impetigo
Topical Antibacterial - Fucidin
Oral Abx - flucloxacillin
Viral Warts
Often Skin Coloured
HPV –> Skin Contact
Treatment: Cryotherapy/Salycilic Acid
Chicken Pox
Varicella Zoster Virus
1 infection = Lifelong immunity (except in immunocompromised)
Red papules and vesicles
Incubation = 10 days
Contagious 1-2 days before rash and unti crusted
Self limiting - Calamine Lotion
Hand Foot and Mouth Disease
EnteroVirus Cocksackie A16 Blisters on hand, feet ad Around Mouth Late Summer/Early Autumn Outbreaks Self-Limiting
What systemic diseases may occur
Orofacial Granulomatosis
Erythema odosum
Dermatisis Herpetiformis
Urticaria
What is Orofacial Granulomatosis
Lip swelling and fissures
Oral Mucosal Lesions: ulcers and tags - cobblestoning
Crohns disease
Clinical Features of erythema nodosum
Fainful erythematous submucosal nodules
Most commonly over the shins
Slow resolution - 6-8 weeks
Causes of Erythema Nodosum
Streptococcal infections IBD Sarcoidosis Drugs Mycobacterium incections Idiopathic
Features of Dermatitis Herpetiformis
Assoc. with coeliac Disease
Itchy blisters can appear in clusters
Symmetrical
Scalp, Shoulders, Buttocks, Elbow and knees
Features of Urticaria
Wheals/Hives
Angioedema (10%)
areas of rash can lat from minutes to hours
Acute = <6 weeks Chronic = >6 weeks and often idiopathic
Causes of Urticaria
infection
Food/Drug allergy
NSAIDS/Opiates
Vaccinations
Rx of Urticaria
Antihistamines
Features of Discoid Eczema`
Discoid pattern that may appear with Atopic Eczema
Features of Pomphlyx
Vesicles that may be intensely itchy
Varicose
Affects legs. Assoc with venous insufficiency
Oedema, varicose veins, inflammation and ulceration.
