Eczema Flashcards
Define eczema
A chronic atopic condition caused by defects in the normal continuity of the skin barrier, leading to inflammation in the skin
Clinical features of eczema
Dry skin and flares of erythematous, poorly demarcated patches that are itchy
In infants cheeks are most commonly affected and nappy area is usually spared
In older children and adults the flexures are commonly affected
Diagnosis of eczema
Itchy skin + 3/5 of:
Visible flexural eczema
History of flexural eczema
History of dry skin
History of asthma or allergic rhinitis (or history of atopy in 1st degree relative if <4 years)
Onset <2 years old (do not use if <4 years old)
Maintenance management of eczema
Emollients - as thick and greasy as tolerated, used as often as possible
Avoid activities that break down skin barrier e.g. bathing in hot water, scratching, soaps and body washes
Management of eczema flares
Emollients, topical steroids, “wet wraps”
Treat any complications e.g. bacterial or viral infections
Very rarely IV antibiotics or oral steroids might be required in very severe flares
Prognostic indicators of severe eczema
Onset at age 3-6 months
Severe disease in childhood
Associated asthma or hay fever
Small family size
High IgE serum levels
What is eczema herpeticum?
Dermatological emergency
Caused by a disseminated HSV infection due to impaired skin protection as a result of atopic dermatitis
Monomorphic vesicular rash which can ulcerate and crust
May be systemic effects, such as fever
Diagnosis confirmed with a swab + Tzanck test
Treatwith IV aciclovir
Complications of eczema
Eczema herpeticum
Superficial bacterial infection
Erythroderma
Effects of topical corticosteroid use
What is erythroderma?
Dermatological emergency
Widespread erythema affecting >90% of the skin surface
Can result in heat and fluid loss, causing hypothermia and systemic symptoms
List the effects of topical corticosteroid use
Skin thinning
Striae
Telangiectasia
