Dermatology Flashcards
What is eczema?
Itchy, dry inflammatory skin disease
What is the commonest type of eczema, particular in children?
Atopic eczema
What is atopy?
Overactive immune response to environmental stimuli
What is an atopic march?
Tendency to have:
Eczema
Asthma
Hayfever
What is the distribution of atopic eczema in infancy?
Face/neck (cheeks)
Can spread more generally
What is the distribution of atopic eczema in older children?
Flexural pattern
antecubital fosse, popliteal fosse, wrists, hands, ankles
Where is the abnormality in atopic eczema?
Filaggrin expression
What do filaggrin proteins do?
Bind the keratin filaments together, also play role in natural moisturising factor
Due to the loss of skin barrier function in atopic eczema, what happens?
Loss of water
Irritants may penetrate
Allergens may penetrate
What can childhood eczema flares be associated with?
Infection/viral illness Environment: central heating/cold air Pets Teething Stress Sometimes no flare
Where does seborrheoic dermatitis normally effect?
Scalp and face
Which age group does seborrheoic dermatitis usually affect?
<3mo
Usually resolved by 12mo
What is seborrheoic dermatitis associated with?
Proliferation of various species of the skin commensal Malassezia in its yeast form
Which fungi is seborrheoic dermatitis associated with?
Malassezia
What is an associated sign of seborrheoic dermatitis in infants?
Cradle cap
What is the treatment for seborrheoic dermatitis?
Emollients, anti fungal creams/shampoos, mild topical steroids
What is the pattern discoid eczema?
Scattered annular/circular patches of itchy eczema
What can discoid eczema present as part of?
Atopic eczema
Where does pomphylx eczema present?
Hand and foot
What is pomphylz eczema characterised by?
Vesicles and intensely itchy
What is exogenous eczema?
Allergic eczema - sensitised to allergen
What type of hypersensitivity is associated with exogenous eczema?
Type IV hypersensitivity
What is irritant eczema associated with?
Repeated contact:
water/soaps
Irritant foods: citrus, tomatoes, chemical irritants
What type of reaction is an immediate reaction to food?
Type 1 reaction
What happens during an immediate reaction to food?
Lip swelling
Facial redness/itching
Anaphylactoid symptoms
What type of reaction is a late reaction to food?
Type IV hypersensitivity
What happens during a late reaction to food?
Worsening of eczema 24/48hrs after ingestion
GI problems
Failure to thrive
Severe eczema unresponsive to treatment
Severe generalised itching - even when skin clear
What are the tests to do for an immediate reaction to food?
Blood test for specific IgE antibodies
Skin prick testing
What are the commonest food allergies?
Milk, soy, peanuts, eggs
What are common airbourne allergens?
House dute mites, pet dander, pollens
What are the tests for late reaction to food?
No test
Dietary restrictions/eliminations 6-8wks
Eliminate one food at a time