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MSK and Soft Tissue > Eczema > Flashcards

Eczema Flashcards

1
Q

Clinical features of eczema?

A
  • Itching
  • Erythema + Oedema
  • Worse Winter (cold) + Summer (hot)
  • Papules /Vesicles /Exudation
  • Flexor surfaces (thin skin)
  • Diffuse, ill-defined patches
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2
Q

Additional clinical features of chronic eczema?

A
  • Less oedema
  • Epidermal thickening
  • +/- lichenification
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3
Q

Exogenous forms of eczema?

A
  • Primary irritant contact dermatitis
  • Allergic contact dermatitis
  • Photodermatitis
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4
Q

Endogenous forms of eczema>

A
  • Atopic eczema
  • Seborrhoeic dermatitis
  • Discoid eczema
  • Varicose / status eczema
  • Endogenous eczema of palms and soles
  • Asteatotic eczema
  • Pompholyx
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5
Q

Atopic eczema model?

A

Genetic predisposition (filaggrin mutation) leads to reduced barrier function. Environmental triggers thus precipitate eczema.

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6
Q

What is discoid eczema?

A

Eczema in scattered, well-demarcated annular patches. Mimics psoriasis and tinea.

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7
Q

Discoid eczema treatment?

A

Potent topical steroids

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8
Q

Pathophysiology of asteatotic eczema?

A

Decreasing lipid content of stratum corneum with increasing age. Susceptible to ‘degreasing agents’.

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9
Q

Distribution of asteatotic eczema?

A

Front of legs.

May also affect lower abdomen / arms

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10
Q

Pattern of asteatotic eczema?

A

Crazy paving pattern

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11
Q

Rx asteatotic eczema.

A
  • Trial emollient

- Often need mild topic steroid ointment

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12
Q

What is pompholyx?

A

Vesicular eczema of hand and foot. very itchy, often related to sweating).

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13
Q

What precipitates pompholyx?

A

Excessive washing and sweating

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14
Q

Rx pompholyx?

A
  • Potent topical steroid
  • Avoidance of soaps and irritants
  • Regular emollients
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15
Q

What is diffuse erythrodermic eczema?

A 
Severe eczema (>90% BSA).
Significant morbidity.
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16
Q

Treatment diffuse erythrodermic eczema?

A

Intense topical steroids and systemic immunosuppression

17
Q

What are the complications of eczema?

A
  • Bacterial superinfection
  • Eczema herpeticum
  • Allergic Contact dermatitis
18
Q

Why is eczematous skin predisposed to bacterial superinfection?

A

Eczematous skin lacks naturally occurring antibacterial peptides.

19
Q

Rx bacterial infection of eczema?

A

Systemic anti-staph ABx (generally infected with Staph aureus).

20
Q

What is eczema herpeticum?

A

Secondary infection by HSV virus. MEDICAL EMERGENCY due to risk of corneal scarring.

21
Q

Clinical features of eczema herpeticum?

A

Sudden onset worsening of pre-existing eczema with painful vesicles and “punched out” erosions.

22
Q

Mx eczema herpeticum?

A
  • Assessment by opthalmologist

- Systemic antiviral treatment

23
Q

How is allergic contact dermatitis diagnosed?

A

Patch testing

24
Q

Pathophysiology of allergic contact dermatitis?

A

Delayed hypersensitivity reaction to an external allergen.

25
Q

General measures to treat eczema?

A
  • Avoid irritants: soap, allergens, pets
  • Regular emollient (mainstay Rx)
  • topical steroids when appropriate
  • Warm showers (not hot)
26
Q

Specific treatment atopic eczema?

A
  • Topical steroid to inflamed areas
  • Mild steroid for face, NSAICream (e.g. pimecrolimus)
  • Treat infection if suspected
27
Q

Treatment options for severe eczema?

A
  • Dermatology referral
  • Wet dressings
  • Phototherapy with UVB
  • Systemic immunomodulators:
  • -short term = prednisolone
  • -long term = azathioprine, cyclosporin, methotrexate
28
Q

What is required for diagnosis of atopic eczema?

A

Itch + 3 of:

-flexural dermatitis (or cheeks if

29
Q

What are the acute signs of dermatitis?

A

Signs of acute inflammation

  • Erythema
  • Oedema / papules
  • Ooze/ crust
  • Vesiculation
  • Excoriations
30
Q

Chronic signs dermatitis?

A
  • Lichenification
  • Dryness
  • Scale
  • Fissuring / cracking
  • Post-inflamm hypo/hyper pigmentation
31
Q

Functional assessment dermatitis impact?

A
  • Sleep
  • Self esteem
  • Bullying
  • Career
  • Cost
  • Time
  • Parental stress
32
Q

What is Koebnerisation?

A

Propensity for lesion or rash to occur in area of previous trauma (e.g. psoriasis, warts, lichen planus)

MSK and Soft Tissue (33 decks)

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