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Dermatology RIA > Eczema > Flashcards

Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

signs of infected eczema

A
  • weeping
  • crusted
  • pustules
  • fever/malaise
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2
Q

tool used to assess severity of eczema

A

Patient Orientated Eczema Measure

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3
Q

where is commonly the first place for eczema to occur in children

A

cheeks

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4
Q

symptoms of eczema

A
  • dry skin
  • itchy
  • redness
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5
Q

what is atopic eczema

A

common inflammatory skin condition

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6
Q

exogenous types of eczema (4)

A
  • atopic
  • varicose
  • seborrhoeic
  • discoid
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7
Q

4 closely linked conditions all of “atopic tendency”

A
  • atopic eczema
  • atopic dermatitis
  • asthma
  • hayfever
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8
Q

triggers of atopic eczema

A
  • soap + detergents
  • overheating/rough clothing
  • skin infection
  • pollens
  • food
  • stress
  • house dust mites
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9
Q

Diagnosis of atopic eczema = child with itchy skin + 3 or more of following:

A

a) visible flexural dermatitis involving skin creases
b) personal hx flexural dermatitis
c) personal hx dry skin in last 12 months
d) personal hx of asthma/allergic rhinitis OR hx atopic disease in a 1st degree relative of children under age of 4 years
e) onset of signs + symptoms under age of 2 years

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10
Q

what is pomphoplyx

A

acute presentation of eczema; tiny vesicles appear typically on lateral aspects of fingers + toes
- intensely itchy

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11
Q

what is lichenification

A

increased skin markings seen in chronic eczema

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12
Q

signs of atopic eczema infected with staph aureus/streptococcus

A
  • weeping
  • pustules
  • crusting
  • atopic eczema failing to respond to therapy
  • rapidly worsening atopic eczema
  • fever/malaise
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13
Q

what is eczema herpeticum

A

HSV virus infecton of atopic eczema

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14
Q

signs of eczema herpeticum

A
  • areas or worsening/painful eczema
  • clustered blisters (consistent with early stage cold sores)
  • punched out erosions
  • fever/lethargy/distress
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15
Q

treatment of bacterial infected eczema

A

Fucidin H cream: applied topically every 12 hours

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16
Q

what is Fusidin H cream

A

combination of abx + steroid to treat both secondary infection and underlying eczema

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17
Q

describe the typical appearance of Eczema Herpeticum

A

punched out erosions

  • circular
  • depressed
  • ulcerated
  • 1-3 mm
  • uniform
  • grouped vesicles
18
Q

complications of systemic herpes simplex

A
  • hepatitis
  • pneumonitis
  • acute renal failure
  • encephalitis
19
Q

lack of what protein leads to skin breakdown

A

flaggrin

20
Q

allergens are taken up by dendritic cells… stimulating an inflammatory cascade; what cells is this cascade predominated by

A

Th2 cells

21
Q

treatment overview for atopic eczema (4)

A
  • emollient therapy
  • steroid creams
  • immunomodulator cream/ointment
  • know when to refer
22
Q

mechanism of benefits of emollient therapy

A

in eczema their is loss of the oily layer in skin –> water can escape from the skin –> crack in the skin –> things can enter and cause irritation –> therapy replaces this lost layer.

23
Q

oily + paraffin based

A

ointments

24
Q

soap substitutes

A

lotions

25
Q

emollient regime (3)

A

combination of

  • ointments
  • lotions
  • moisturiser
26
Q

frequency of emollient therapy

A

application of ointments _ creams 3x/day

27
Q

when to apply steroids

A

after allowing moisturised to dry into skin for 20 minutea

28
Q

strength of steroid determined by

A

site + severity + age

29
Q

an alternative to topical steroids ?

and mechanism

A

Topical calcineurin inhibitos

  • Tacrolimas
  • Pimecrolimus

suppress T lymphocytes –> suppressing synthesis of pro inflammatory cytokines

30
Q

indication for topical calcineurin inhibitors?

A
  • 2nd line trx of moderate to severe atopic eczema that has not been controlled by topical steroids
  • risk of adverse effects of topical steroids e.g. skin atrophy
31
Q

steroid of choice for mild eczema flare up

A

HYDROCORTISONE

32
Q

steroid of choice for moderate eczema flare up

A

EUMOVATE

33
Q

steroid of choice for severe eczema flare up

A

BETNOVATE

34
Q

steroid of choice for very severe eczema flare up

A

DERMOVATE

35
Q

steroid ladder:

A

hydrocortisone –> euvomate –> betnovate –> dermovate

36
Q

define erythroderma

A

erythema affecting > 90% body

37
Q

what does the maintenance therapy aim to do?

A

create an artificial barrier over the skin to compensate for defective skin barrier (thick & greasy emollients)

38
Q

side effects of topical steroid therapy

A
  • skin thinning
  • telengiectasia
  • systemic absorption
39
Q

why does bacterial infection happen?

A

opportunistic bacteria infect the skin through the entry points in the breakdown of skin

40
Q

features of the vesicles found in eczema herpeticum

A

the vesicles contain pus & can burst & leave small punched out lesions

41
Q

features of the punched out lesions in eczema herpeticum (3)

A
  • circular
  • depressed
  • ulcerated
42
Q

4 year old with facial eczema - what steroid treatment would you recommend?

A

Mild steroid = 1% Hydrocortisone ointment

for a short duration e.g. 3-5 days

Dermatology RIA (7 decks)

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