Eczema

Question 1

Define eczema

Answer 1

Pruritic papulovesicular skin reaction to endogenous & exogenous agents

Question 2

Aetiology of eczema

general + 2 groups

Answer 2

Lots of types as there’s many different triggers

Exogenous
Endogenous

Question 3

Aetiology of eczema - exogenous

3

Answer 3

Irritants (e.g. nappy rash)
Contact (delayed type 4 hypersensitivity reaction to an allergen)
Atopic

Question 4

Aetiology of eczema - endogenous

5

Answer 4

Atopic
Seborrhoeic
Pompholyx (type that affects hand & feet)
Varicose - due to increased venous pressure in lower limbs
Lichen simplex

Question 5

Epidemiology of eczema

contact & atopic prevalence

Answer 5

Contact - 4% prevalence

Atopic - onset in 1st year of life, 10-20% childhood incidence

Question 6

Presenting symptoms of eczema

6

Answer 6

Itching
Heat 
Tenderness
Redness
Weeping
Crusting

Question 7

Signs of eczema on physical examination

3 groups

Answer 7

Acute
Chronic
Based on type of eczema

Question 8

Signs of eczema on physical examination - acute

4

Answer 8

Poorly demarcated erythematous oedematous dry scaling patches
Papules
Vesicles w/ exudation & crusting
Excoriation marks

Question 9

Signs of eczema on physical examination - chronic

4

Answer 9

Thickened epidermis
Skin lichenification
Fissures
Change in pigmentation

Question 10

Signs of eczema on physical examination - based on type

6

Answer 10

Atopic - mainly affects face & flexures
Seborrhoeic - yellow greasy scales on erythematous plaques, commonly found on eyebrows, scalp, presternal area
Pompholyx - vesiculobullous eruption on palms & soles
Varicose - associated w/ marked varicose veins
Nummular - coin shaped, on legs & trunk
Asteatotic - dry, crazy paring pattern

Question 11

Investigations for contact eczema

Answer 11

Skin patching test - disc containing allergen is diluted & applied to skin for 48 hrs (if positive causes red raised lesion)

Question 12

Investigations for atopic eczema

Answer 12

Lab testing (e.g. IgE levels)