Eczema Flashcards
Eczema (dermatitis) refers to a variety of skin conditions characterised by epidermal ______________ and ______________
inflammation
itching
What are the main types of eczema? (5)
- Irritant
- Allergic contact
- Atopic
- Venous
- Discoid
________________, due to scratching and rubbing, often presents in chronic eczema.
Lichenification
Lichenification, due to scratching and rubbing, often presents in _______________.
chronic eczema
____________ eczema is one of the most common types and it usually involves itchy, red, dry skin which can become infected and lichenified
Atopic
Atopic eczema is one of the most common types and it usually involves itchy, red, dry skin which can become ____________ and ____________
infected
lichenified
Management of eczema involves the removal or treatment of contributory factors including ______________ and ______________ irritants
occupational
domestic
Frequent and liberal use of ______________ is advised for dry skin and itching associated with eczema
emollients
Emollients increase the efficacy of ______________ and have a steroid sparing action
topical corticosteroids
The use of _______________ should continue even if the eczema improves or if other treatment is being used
emollients
The use of emollients should ________________ if the eczema improves or if other treatment is being used
continue even
Aqueous cream is generally not recommended due to the high risk of developing _______________
skin reactions
In addition to emollients, __________________ are also often required in the management of eczema
Topical corticosteroids
For eczema on the face, genitals, or axillae, consider a ___________ potency topical corticosteroid
mild
*and only increase to a moderate potency topical corticosteroid if necessary
______________ (strength) topical corticosteroids are generally required for use in adults with moderate or severe eczema on the scalp, limbs, and trunk
Moderate to potent
In patients with frequent flares, a ____________ can be applied to prevent further flares using various regimens (e.g. on 2 consecutive days each week)
topical corticosteroid
Under the care of a specialist, _________________ are sometimes applied over topical corticosteroids or emollients to treat eczema of the limbs
bandages (including those containing ichthammol with zinc oxide)
______________ dressings can be used to provide a physical barrier to help prevent scratching and improve retention of emollients
Dry-wrap
Topical _____________ is licensed for the treatment of mild to moderate atopic eczema. _____________ is licensed for topical use in the treatment of moderate to severe atopic eczema
pimecrolimus
Tacrolimus
- Both are calcineurin inhibitors and should be considered as a second-line treatment option only, unless there is a specific reason to avoid or reduce the use of topical corticosteroids
Are antihistamines recommended for routine use in the management of atopic eczema?
Not for routine use; However, if there is severe itching or urticaria, consider a non-sedating antihistamine. A sedating antihistamine can be considered if itching causes sleep disturbance
If there is severe itching or urticaria associated with atopic eczema, consider a _______________. A sedating antihistamine can be considered if itching causes sleep disturbance
non-sedating antihistamine
However, if there is severe itching or urticaria, consider a non-sedating antihistamine. A ________________ can be considered if itching causes sleep disturbance
sedating antihistamine
Breaks in the skin caused by eczema are susceptible to ___________________
bacterial infection (commonly with Staphylococcus aureus and occasionally with Streptococcus pyogenes) and may require treatment with a topical or systemic antibacterial
Breaks in the skin caused by eczema are susceptible to bacterial infection (commonly with ________________ and occasionally with ________________) and may require treatment with a topical or systemic antibacterial
Staphylococcus aureus
Streptococcus pyogenes
Episodes of infected eczema usually co-exist with a flare and will require management with treatments such as _________________ and ________________
emollients
topical corticosteroids
Eczema can also be infected with _______________ virus
herpes simplex
*Immediate referral to secondary care is required in patients presenting with suspected eczema herpeticum
What is eczema herpeticum?
Eczema infected with herpes simplex virus
What is the drug management of severe refractory eczema?
Systemic drugs acting on the immune system eg cyclosporin, azathioprine (unlicensed), mycophenolate (unlicensed), phototherapy
Which drugs are used in the treatment of moderate to sever atopic eczema? (2)
Dupilumab
Baricitinib
____________ is licensed for the treatment of severe chronic hand eczema refractory to potent topical corticosteroids
Alitretinoin
patients with ______________ features of eczema are more likely to respond to alitretinoin than those with pompholyx
hyperkeratotic
What is pompholyx?
Also known as dyshidrotic eczema, a type of eczema where tiny blisters develop across the fingers, palms and hands and sometimes the soles of the feet
Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the yeast ______________ and affects the scalp, paranasal areas, and eyebrows
Malassezia
Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the ____________ Malassezia and affects the scalp, paranasal areas, and eyebrows
yeast
Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the yeast Malassezia and affects the ______________, ____________ areas, and ______________
scalp
paranasal
eyebrows
Shampoos active against Malassezia (including those containing _______________ or _____________) and combinations of mild topical corticosteroids with suitable antimicrobials are used
ketoconazole
coal tar
