Eczema Flashcards
What is atopic eczema/atopic dermatitis?
A chronic, itchy, inflammatory condition that affects people of all ages, although it presents most frequently in childhood.
What are the causes for atopic eczema/dermatitis?
- No known single cause
- Many genetic, immunologic, environmental factors leading to a dysfunctional skin barrier and immune system dysregulation
Triggers - Soap, animals, dust mites, rough clothing, stress, pollen
What are complications for atopic eczema?
Infection - Staph aureus, Herpes simplex (eczema herpeticum), superficial fungal infections
Psychosocial problems - Depression, distress, behavioural problems, impaired performance of school, poor self image, sleep disturbance
What is the typical history of atopic eczema?
- Pruritis
- Rash starts in infancy and is episodic in nature
- History of atopy eg allergic rhinitis, asthma
- Triggers that patient can identify
- Family history
Describe the rash of atopic eczema?
Acute:
- Itchy papules and vesicles often weeping (exudative)
- Poor demarkation
Chronic:
- Dry pruritic scaly patches
- Erythematous
- Paler grey/brown in richly pigmented skin
- Common on extensor aspect of limbs in infants, and flexor aspects in children and adults
- Chronic scratching leads to lichenification
What general measures are there for the management of eczema?
- Avoid known exacerbating agents
What topical treatments are there for atopic eczema?
- Emollients applied frequently and liberally
- Mild topical corticosteroids (hydrocortisone 1%) for areas of red skin, treatment until 48hrs after the flare has been controlled
- Topical calcineurin inhibitors (tacrolimus)
- Bandages
- Phototherapy
What medication is there for atopic eczema?
- Oral corticosteroids
What is the management for infected eczema?
- Do not routinely offer a topical/oral antibiotic for a secondary bacterial infection of eczema
- Flucloxacillin is first line choice
- If localised infection, consider fusidic acid
