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Dermatology AM > Eczema > Flashcards

Eczema Flashcards

1
Q

What is eczema?

A

Common inflammatory skin condition, causing spongiosis within epidermis, acanthosis and inflammation

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2
Q

What causes eczema?

A

Wide range of external and internal factors- genetics, epidermal barrier dysfunction and environment

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3
Q

What genetics can contribute to eczema?

A

Atopic family history

Filaggrin gene

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4
Q

What can cause acute flares of eczema?

A

Viral illness
Stress
Environment- heat, cold, allergens
Food allergens

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5
Q

What are the clinical features of eczema?

A 
Itch
Redness
Scaling
Papules
Vesicles
Mostly seen in flexures
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6
Q

Where does eczema tend to start on babies?

A

Fave

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7
Q

What chronic changes are seen in eczema?

A

Lichenification
Plaques
Fissuring

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8
Q

What are the endogenous causes of eczema?

A 
Atopic eczema
Seborrhoeic dermatitis
Discoid eczema
Venous eczema
Pompholyx eczema
Juvenile plantar dermatitis
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9
Q

What is atopic eczema?

A

Itchy skin condone in the last 2 months plus 2 of the following

  • onset before age 2
  • hitory of flexural involvement
  • history of generally dry skin
  • history of other atopic disease or family history of
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10
Q

What are the clinical features of seborrhoea dermatitis in infants?

A

Scalp and proximal flexure pattern
Usually <6 months
Often clears within weeks of treatment

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11
Q

What is the presentation of seborrhoea eczema in adults?

A

Chronic dermatitis
Red, sharply margined lesions covered with greasy looking scales
Distrubuted over areas rich in sebaceous glands- scalp, face and trunk
Dandruff often recursor

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12
Q

What is the causative organism of seborrhoea eczema?

A

Malassezia yeast

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13
Q

What is the treatment of seborrhoea eczema?

A

Topical anti-yeast and HIV test if severe

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14
Q

What are the clinical features of discoid eczema?

A

Circular plaques of eczema

Cause ten unknown but may develop at sites of trauma/irritation

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15
Q

What are the clinical features of venous eczema?

A

Increased venous pressure and oedema
Ankle and lower leg involved
Resolution f oedema beneficial

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16
Q

What are the clinical features of pompholyx eczema?

A 
Intensely itchy
Distributed across palms and soles of feet
Sudden onset of crops of vesicles
More common <40
Resolution can include desquamation
17
Q

What are the types of exogenous eczema?

A 
Allergic contact dermatitis
Irritant contact dermatitis
Lichem simplex
Photoallergic or photoaggravated eczema
Asteatotic eczema
Eczema herpeticum
18
Q

What type of reaction is allergic contact dermatitis?

A

Type 4 hypersensitivity

19
Q

How long can it take for allergic contact dermatitis to develop?

A

48-72 hours

20
Q

What is the immune process of allergic contact dermatitis?

A

Antigen presenting cells take allergen to lymph nodes and present it to naive T cells
Clonal expansion of T cells released into bloodstream, causing mast cell degranulation, vasodilation and draws in neutrophils

21
Q

What can cause irritant contact dermatitis?

A

Friction- microtrauma or cumulative

Environmental- cold, overexposure to water, chemicals

22
Q

Who is irritant contact dermatitis often seen in?

A

Hairdressers, cleaners, NHS staff

23
Q

What is the testing for contact dermatitis?

A

Patch testing

24
Q

How is patch testing for irritant contact dermatitis done?

A

Potential allergens applied the Monday, removed on the Wednesday and skin erased on the friday

25
Q

What are the clinical features of asteatotic eczema?

A

Very dry skin
Cracked, scaly appearance
Most commonly shins affected

26
Q

What causes asteatotic dermatitis?

A

Heat

Excessive washing/soaps

27
Q

What is eczema herpeticum?

A

Disseminated viral infection on top of poorly controlled eczema

28
Q

What are the clinical features of eczema herpeticum?

A

Fever and often systemically unwell
Itchy clusters of blisters and erosions
Swollen lymph glands

29
Q

What is the treatment of eczema?

A 
Avoid causative and exacerbating factors
Emollients
Soap substitutes
Intermittent topical steroids
Sometimes antihistamines/antimicrobials
Calcineuri n inhibitors
30
Q

What topical steroids can be used to treat eczema?

A

Hydrocortisone

Betamethasone

31
Q

What calcineurin inhibitors can be used in the treatment of eczema?

A

Topical pimecrolimus and tacrolimus

32
Q

What is the treatment of severe eczema?

A

UV light

Immunosuppression

33
Q

What immunosuppressants can be used to treat severe eczema?

A

Azathioprine
Ciclosporin
Methotrexate

Dermatology AM (9 decks)

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