Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology > Eczema > Flashcards

Eczema Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

How common is eczema?

A

24% of children will be diagnosed with eczema at some point in their childhood

Prevalence is rising

Rates of hospital admission for children and adults is increasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is eczema also known as?

A

Atopic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is eczema?

A

A common INFLAMMATORY skin condition.

Commonly affects FLEXURAL areas.

Multiple types and a spectrum of severity

Wide range of external (exogenous) or internal (endogenous) factors can induce the condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the epidemiology of eczema?

A

Overall prevalence is 4% in Western countries

Most commonly appears in babies and children
-By adult life 60% have cleared

Recent studies indicated rising numbers

  • More so in”developed” regions
  • Social class effect?
  • Commoner in cooler climates?
  • Pollution? Other environmental factors?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the definition of atopic eczema?

A

An itchy skin condition in the last 12 months

Plus 3 of the following:

  • Onset before age 2
  • History of flexural involvement
  • History of generally dry skin
  • History of other atopic disease
  • –History in 1st degree relative if under 4 yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are genetics involved in the pathogenesis of atopic eczema?

A

Many genes implicated

Key role for Filaggrin gene

Atopic family history
-May develop any or all of three closely linked conditions; atopic eczema, asthma and hay fever (allergic rhinitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What factors are involved in pathogenesis of atopic eczema?

A

Genetics

Epidermal Barrier dysfunction

Environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the histology of atopic eczema

A

Spongiosis within the epidermis

Acanthosis

Inflammation - superficial perivascular lymphohistiocytic infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is spongiosis?

A

Spongiosis is mainly intercellular edema (abnormal accumulation of fluid) in the epidermis, and is characteristic of eczematous dermatitis, manifested clinically by intraepidermal vesicles (fluid-containing spaces), “juicy” papules, and/or lichenification.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is acanthosis?

A

Acanthosis is diffuse epidermal hyperplasia (thickening of the skin). It implies increased thickness of the Malpighian layer (stratum basale and stratum spinosum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the clinical features of atopic eczema?

A

ITCH

Distribution

  • Flexures, Neck, Eyelids, Face, Hands and feet
  • Tends to spare nappy area

Acute changes

  • Pruritus, Erythema, Scale, Papules, Vesicles
  • Exuate, crusting, excoriation

Chronic changes
-Lichenification, Plaques, Fissuring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is excoriation?

A

A scratch or abrasion to the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is lichenification?

A

Thick, leathery skin, usually the result of constant scratching and rubbing.

With prolonged rubbing or scratching, the outer layer of the skin (the epidermis) becomes hypertrophied (overgrown) and this results in thickening of the skin and exaggeration of the normal skin markings, giving the skin a leathery bark-like appearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the types of endogenous eczema?

A
  • Atopic
  • Discoid
  • Venous
  • Seborrhoeic dermatitis
  • Pompholyx
  • Juvenile plantar dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the types of exogenous eczema?

A

Contact dermatitis

  • Irritant
  • Allergic

Lichen simplex

Photoallergic contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the pathogenesis of allergic contact dermatitis?

A

Type 4 Hypersensitivity
-Delayed hypersensitivity (can take 48-72hrs to develop reaction)

Antigen presenting cells tale happen/ allergen to LN and present to niave T cells

Clonal expansion of these T cells, released into blood stream

When these T cells next encounter hapten
-Mast cell degranulation, vasodilation and neutrophils

17
Q

How does patch testing work?

A

Potential allergens applied (NO needles involved)

Baseline/standard series - applied to all patients

Applied Monday

Remove Wednesday

Re-assess friday

18
Q

What is irritant contact dermatitis?

A

Form of contact dermatitis in which the skin injured by…

FRICTION

  • Microtrauma
  • Cumulative

ENVIRONMENTAL FACTORS

  • Cold
  • Over exposure to water
  • Chemicals such as acids, alkalis, detergents and solvents
19
Q

What occupations are at risk of contact dermatitis?

A

Hairdressers

NHS staff

Cleaners

Dermatitis -> under a ring on finger -> soaps can accumulate -> irritant

Nappy rash

20
Q

What is seborrhoeic dermatitis?

A

Seborrheic dermatitis is an inflammatory skin disorder affecting the scalp, face, torso and proximal flexures.

Typically, seborrheic dermatitis presents with scaly, flaky, itchy, and red skin.

It particularly affects the sebaceous-gland-rich areas of skin.

21
Q

Describe seborrhoeic eczema in adults

A

In adolescents and adults, seborrhoeic dermatitis usually presents as scalp scaling similar to dandruff or as mild to marked erythema of the nasolabial fold.

Red, sharply marginated lesions covered with greasy looking scales

22
Q

How do you treat seborrhoeic eczema?

A

Malassezia yeast increased in the scaly epidermis of dandruff and seborrheoic dermatitis.

Treat with topical anti-yeast (ketoconazole)

23
Q

What is discoid eczema?

A

Circular plaques of eczema

Cause often unknown

May develop at sites of trauma/ irritation

24
Q

What is pompholyx/ vesicular eczema?

A

Palms and soles

Intensely itchy

More common in under 40s

Sudden onset of crops of vesicles

Resolution can include desquamation

25
Q

What is asteatotic eczema?

A

Very dry skin
Cracked scaly appearance

Most commonly shins affected
Climate- heat
Excessive washing/soaps

26
Q

What is venous eczema?

A

Stasis eczema or varicose eczema

Increased venous pressure

Oedema

Ankle and lower leg involved

Resolution of oedema can help -> compression stockings

27
Q

What is eczema herpeticum?

A

Disseminated viral infection

Fever and often unwell

Itchy clusters of blisters and erosions

Herpes Simplex 1 and 2

Swollen lymph glands

28
Q

What should you consider in eczema herpeticum?

A

Consider admission

Antivirals

Consider secondary bacterial infection

29
Q

How do you treat eczema?

A
  • Patient education
  • Avoid causative/ exacerbating factors

Emollients (moisturisers)

Soap substitutes

Sedating antihistamines (if needed)

Intermittent topical steroids

Antimicrobials

Calcineurin inhibitors
-Topical pimecrolimus and tacrolimus

UV light

Immunosuppression

30
Q

What types of emollients can you consider giving?

A
  • Ointment (greasy but effective)
  • Creams (lighter)
  • Lotions (more watery)
31
Q

What different intermittant topical steroids can you consider giving?

A

Different potency

  • Hydrocortisone (low)
  • Betamethasone (potent)
32
Q

What immunosuppression can you consider giving?

A

Azathioprine
Ciclosporin
Mycophenolate mofetil
Methotrexate

33
Q

What are the benefits of topical steroids?

A

Fast and effective short-term treatment

34
Q

What are the potential cutaneous risks of topical steroids?

A

Skin atrophy/ striae

Telangiectasia, pigmentation abnormalities

Acneform, rosacea-like eruptions

Glaucoma

35
Q

What are the potential systemic risks from topical steroids?

A

Growth retardation

Cushing’s syndrome

Dermatology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions