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Dermatology > Eczema > Flashcards

Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

Define eczema

A

dermatitis

terms can be used interchangeably

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2
Q

List eczema types

A

atopic eczema
irritant contact eczema
allergic contact eczema
varicose eczema
stasis/gravitational eczema
asteatotic eczema
discoid
seborrhoeic
lichen simplex

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3
Q

Describe pompholyx

A

itchy bubbles of fluid down sides of fingers

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4
Q

Atopic eczema causes

A

atopic genes

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5
Q

Irritant contact eczema causes

A

irritants

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6
Q

Allergic contact eczema causes

A

contact allergy

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7
Q

Varicose eczema causes

A

varicose veins

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8
Q

Gravitational/stasis eczema causes

A

standing
occupation
wheelchair

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9
Q

Seborrhoeic eczema causes

A

yeast sensitivity

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10
Q

Discoid eczema causes

A

bacteria on skin

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11
Q

Lichen simplex causes

A

eczema
scratch cycle

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12
Q

Eczema symptoms

A

Itch:
- scratch
- bleed
- affected sleep
- concentration loss
- anger

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13
Q

What is DLQI?

A

Dermatology Life Quality Index
effect of dermatological condition on patient’s life

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14
Q

Eczema signs

A

erythema
scale
excoriation (scratch marks)
exudate (weeping)
crusting (scab)
hyperkeratosis (thick skin)
lichenification (increased skin markings due to rubbing)
vesicles (little blisters)

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15
Q

What causes erythema?

A

more blood or more translucent skin

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16
Q

What causes scale?

A

excessive production of epidermis which peels off or stays stuck to the top layer sp becomes thick`

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17
Q

What is lichenification?

A

thickened hyperkeratotic skin due to rubbing with more lines/wrinkles

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18
Q

What causes exudate?

A

fluid oozing which dris to form crust

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19
Q

What causes vesicles?

A

fluid accumulating in epidermis due to inflammation

20
Q

Describe atopic eczema

A

adult or child
associated with fillagrin gene abnormalities
makes skin ‘leaky’
so things irritate easily
use oil on skin to ‘waterproof’ skin
linked with other atopic diseases (asthma, hayfever, urticaria)

21
Q

List 4 atopic diseases

A

asthma
hayfever (allergic rhinitis)
eczema
urticaria

22
Q

Difference between cream and ointment?

A

ointment has more oil than cream

23
Q

What units are used for steroid creams?

A

fingertip units

24
Q

Mild steroid example

A

Hydrocortisone 1%

25
Q

Medium steroid example

A

Eumovate
generic name = clobitasone

26
Q

Potent steroid example

A

Betnovate

27
Q

Very potent steroid example

A

Dermovate
generic name = clobitasol

28
Q

What is asteatotic eczema?

A

lack of oil
more oil removed than produced
looks like dry river bed

29
Q

Asteatotic eczema treatment

A

bathe less often, shorter and cooler
use less detergent
apply oil to skin

30
Q

Describe irritant contact eczema

A

many chemicals can irritate skin cells
irritation is not the same as allergy (allergy = due to immune process)
yellow crust = secondary infection

31
Q

Describe allergic contact eczema

A

few to 96 hours after contact
common causes = nickel, fragrance, rubber accelerators, chromate, formaldehyde, plants
investigate with patch tests

32
Q

Describe how to carry out a patch test

A

apply patches day 1
remove day 3
read days 3 and 5
select batteries according to history and distribution

33
Q

Describe varicose eczema

A

stasis = gravitational
important as commonly breaks down (infection or scratching) to form leg ulcer

34
Q

How is venous stasis treated?

A

lose weight
exercise
elevate legs
avoid standing/sitting for long periods
compression bandages
varicose vein surgery

35
Q

Why should you use weaker steroids on occluded areas?

A

occlusion causes increased penetration of steroid
eg. armpits

36
Q

Describe infected eczema

A

often due to scratching
commonly due to staph aureus infection
produce yellow crusts and/or blisters of impetigo (impetiginised eczema)

37
Q

Viral causes of infected eczema

A

Herpes Simplex
-causes cold sores

Eczema Herpeticum

38
Q

Describe discoid eczema

A

round/disc-shaped
variant of bacterial infected eczema
odd pattern often confused with psoriasis
- has follicular areas, less well-defined and lacks psoriasis scale
antibiotic or antiseptic/steroid combinations needed
often co-exists with small areas of follicular eczema

39
Q

Describe pompholyx eczema

A

little blisters down sides of fingers
intensely itchy
episodic
can be due to allergy or endogenous
stronger steroids needed as skin thicker

40
Q

Describe seborrhoeic eczema

A

due to sensitivity to yeast on skin
not due to yeast in diet
very common + made worse by stress
severe in HIV
causes dandruff, rash on eyebrows, nose, nasolabial folds + flexures
treat with systemic or topical antifungals +/- corticosteroid creams

41
Q

Eczema general treatments

A

emollients if dry
antiseptic soaks if oozing
topical steroids depending on degree of inflammation
antibiotic courses if infected or discoid
antifungals if seborrhoeic
antivirals if herpes
bandaging if scratching
elevation etc if stasis
local PUVA (can reach dermis)
oral alitretinoin (if on hands)
oral azathioprine, ciclosporin

42
Q

What skin layer can UVA reach?

A

dermis

43
Q

What skin layer can UVB reach?

A

epidermis

44
Q

Eczema differential diagnoses

A

scabies (burrows between fingers, friends/family usually affected)

fungal infection hands (often unilateral)

psoriasis (can be itchy - different physical signs)

drug eruption (take a good history to exclude)

rarer diseases (eg. bullous pemphigoid, dermatitis, herpetiformis, mycosis fungoides)

45
Q

Describe fungal (tinea) hand infection

A

fine silver scale in the creases
lack of cracking
unilateral
take fungal scrapings if unsure

46
Q

What nail changes can occur in psoriasis and discoid eczema?

A

pitting
onycholysis

Dermatology (23 decks)

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