Eczema Flashcards
What is Eczema?
A chronic atopic condition caused by defects in the normal continuity of the skin barrier, leading to inflammation.
Environmental Triggers of Eczema (5).
- Change in Temperature.
- Certain Dietary Products.
- Washing Powders.
- Cleaning Products.
- Emotional Events/Stresses.
Pathophysiology of Eczema (3).
- Defect in Barrier of Skin.
- Entry of Irritants, Microbes and Allergens.
- Immune Response - Inflammation.
Clinical Features of Eczema.
Dry red itchy sore patches of skin over flexor surfaces, face and neck.
Maintenance Management of Eczema (2).
Aim : Create Artificial Barrier -
- Emollients and Soap Substitutes.
- Avoid Activities that Break Barrier e.g. Hot Water Bath, Scratching, Scrubbing, Soaps/Body Washes that Remove Natural Oils.
Steroid Ladder in Eczema (4).
- Mild : Hydrocortisone.
- Moderate : Eumovate.
- Strong : Betnovate.
- Intense : Dermovate.
Steroid Rules in Eczema (2).
- Weakest Steroid for Shortest Period to get Skin Under Control.
- 1 FTU - Finger Tip Unit is sufficient to treat a skin area about twice that of the flat of an adult hand.
Adverse Effects of Topical Steroids (3).
- Thinning of Skin (More Vulnerable to Flares, Bruising and Damage).
- Systemic Absorption.
- Telangiectasia.
Flare Management of Eczema (4).
- Thicker Emollient.
- Topical Steroids.
- Wet Wraps (Thick Emollient and Wrap to Keep Moisture Locked In).
- Complication Treatment - Infection (IV Antibiotics, Oral Steroids).
Specialist Management of Severe Eczema (4).
- Zinc Impregnated Bandages.
- Topical Tacrolimus.
- Phototherapy.
- Systemic Immunosuppressants.
Complication of Eczema.
- Opportunistic Bacterial Infection - S. aureus (Oral Antibiotic = Flucloxacillin).
- Kids - Eczema Herpeticum.
- Erythroderma.
What is Erythroderma?
Dermatological Malignancy : Widespread erythema affecting >90% of skin surface - heat and fluid loss.
Aetiology of Erythroderma.
Exacerbation of Pre-Existing Skin Condition e.g. Dermatitis, Psoriasis, Pityriasis Rubra Pillars.
Management of Erythroderma.
Supportive - Fluids, Emollients and Underlying Cause.
What is Eczema Herpeticum?
Dermatological Emergency : Viral skin infection in patients with eczema caused by HSV-1 or VZV.
Clinical Presentation of Eczema Herpeticum (3).
- Widespread erythematous painful vesicular rash with systemic symptoms and lymphadenopathy.
- Coldsore.
- Pre-Existing Skin Condition.
Rash in Eczema Herpeticum (6).
- Widespread.
- Erythematous.
- Painful.
- Itchy.
- Vesicles with Pus - Burst.
- Punched-Out Ulcers with Red Base.
Management in Eczema Herpeticum (2).
- Viral Swabs (Diagnostic).
2. Start Management Based on Clinical Appearance - Aciclovir.
What is Seborrheic Dermatitis?
Dermatitis affecting areas of skin rich in sebaceous glands.
Presentation of Seborrheic Dermatitis.
- Ill-Defined.
- Greasy.
- Flaky Scales.
- Erythematous Background.
- Sebum-Rich Area : Nasolabial Fold, Posterior Auricular Skin and Scalp.
- Otitis Externa, Blepharitis (Complication).
- HIV, Parkinson’s (Associations).
Pathophysiology of Seborrheic Dermatitis.
Proliferation of a yeast (M. furfural) on skin causes inflammation.
Management of Seborrheic Dermatitis.
- Zinc Pyrithione Shampoo (OTC).
- Ketoconazole Shampoo/Cream.
- Short Course of Topical Steroid.
Management of Infantile Seborrheic Dermatitis.
Topical Emollient - Olive Oil Massaged to Scalp and Brush Scales gently off.
Presentation of Infantile Seborrheic Dermatitis.
Cradle Cap - Diffuse yellow greasy scales with no underlying erythema - scalp, armpit or groin.
