Eczema Flashcards
Define eczema.
Eczema is an inflammatory skin condition characterised by dry, pruritic skin with a chronic relapsing course.
Explain the aetiology of eczema.
Eczema has a multifactorial aetiology, with a combination of genetic susceptibility and environmental factors contributing to disease development. Defects in the skin’s barrier function and immune dysregulation following allergen exposure are key components in the development of this disease.
What are risk factors for eczema?
Age <5
Asthma
Family history of eczema
Allergic rhinitis
Active and passive exposure to smoke
Summarise the epidemiology of eczema.
It can affect all age groups, but it is most commonly diagnosed before 5 years of age and affects 10% to 20% of children. Eczema usually presents in childhood, with 45% of patients diagnosed by 6 months of age, and 70% to 85% by 5 years of age.
Recognise the presenting symptoms of eczema. Recognise the signs of eczema on physical examination.
Pruritus
Xerosis (dry skin)
Erythema
Scaling
Vesicles
Papules
Keratosis pilaris
Excoriations
Lichenification
Hypopigmentation
Identify appropriate investigations for eczema and interpret the results.
No investigations are needed.
What is the management for eczema?
Emollients
Topical corticosteroid creams
What are complications associated with eczema?
Psychological stress
Systemic adverse effects of topical corticosteroids and medications
Malignancy related to use of topical calcineurin inhibitors
Eczema herpeticum
What is the prognosis of eczema?
Eczema is a chronic disease with a varying course. Approximately 60% of children will have symptom resolution as they enter puberty, but relapse may occur in 50%.
What are the different types of eczema?
Atopic
Contact
Discoid
Dyshidrotic
Herpeticum
Seborrhoeic
What is atopic eczema?
Atopic eczema is the most common form.
Skin is cracked and dry and may bleed when scratched.
What is contact eczema?
Contact dermatitis
A rash triggered due to an allergic reaction after coming into contact with a substance.
What is discoid eczema?
Discoid eczema causes distinctive circular or oval patches of eczema. It can affect any part of the body, although it does not usually affect the face or scalp.
What is eczema herpeticum?
Eczema herpeticum is a disseminated viral infection characterised by fever and clusters of itchy blisters or punched-out erosions. It is most often seen as a complication of atopic dermatitis/eczema.
Most cases of eczema herpeticum are due to HSV type 1 or 2.
Eczema herpeticum usually arises during a first episode of infection with Herpes simplex (primary herpes). Signs appear 5–12 days after contact with an infected individual, who may or may not have visible cold sores.
Patient appears unwell, with fever. Infection may spread to organs and have secondary bacterial infections from staph or strep.
What is seborrhoeic eczema?
Eczema mostly affecting the scalp.
It causes scaly patches, red skin and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest.
May go away by itself with gentle cleaning.
