Eczema Flashcards
What is the presentation of eczema?
Eczema or dermatitis is a rash with inflamed red skin that is poorly demarcated. It is often itchy and painful. Barrier function of the epidermis is abnormal and the skin is easily irritated
What is the management for atopic eczema?
Involves trying to identify and avoid allergens if there is a clear trigger
Most children grow out of atopic eczema by 13
Explain control not cure
Emollients should be used liberally as they treat the dryness and act as a barrier
Topical corticosteroids can be used for exacerbations, apply 30 mins after emollient
Topical tacrolimus (immunosupressive) can be used if steroids unsuccessful
Systemic ciclosporin or methotrexate can be used in severe disease
What are the different potency corticosteroids that can be used for skin conditions? (steroid ladder)
Mild is hydrocortisone 0.5 or 1%
Moderate is betanovate
Very potent is dermovate
What are the side effects of topical corticosteroids?
Skin thinning
Irreversible striae
telangectasia
worsening untreated infections
What type of eczema is an emergency?
If there is a severe weeping rash then this could inidcate an eczema herpeticum (primary herpes infection) that could be fatal, this requires urgent referral
What are the different types of eczema?
Generally split into endogenous and exogenous Endogenous eczema involes: -Atopic -Seborrhoeic -varicose -discoid Exogenous involves: -Allergic contact (type IV) -Irritant contact
How is a diagnosis of atopic eczema made?
More than 3 of:
-onset before 2 years old
-Past flexural involvement
-History of dry skin
-History of other atopy or in 1st degree relative
-Visible flexural dermatitis
There may be lichenification or post inflammatory hypo or hyperpigmentation
How is testing done for contact dermatitis?
Test strips put on for 48 hours then removed
Final readings at 96 hours
How is a type I IgE mediated reaction tested for?
This is tested for with skin prick testing
