Eczema

Question 1

Dermatitis

Answer 1

Inflammation of skin

Question 2

Eczema

Answer 2

Patches of skin become rough and inflamed with blisters causing itching and bleeding. Often presents in infancy but at anytime

Question 3

Type of Eczema: Endogenous

Answer 3

Atopic, Discoid, Pompholyx, Gravitational, Seborrhoeic

Question 4

Type of Eczema: Exogenous

Answer 4

Irritant, Allergic, Photodermatitis

Question 5

Atopic triad

Answer 5

Eczema, Asthma, Hayfever

Question 6

Criteria of Atopic Eczema

Answer 6

Itchy skin condition
Onset < 2years
Skin crease involvement (includes cheeks)
Dry skin
First degree relative of atopic disease
Visual flexural dermatitis

Question 7

Cause of Atopic Eczema

Answer 7

• Mutation in filagrin- dry skin

- Immune dysregulation- production of Th2 cells

Question 8

Aggravating factors for Eczema

Answer 8

Dryness, Stress, Infection, Allergy

Question 9

Infantile Eczema

Answer 9

Usually starts on the face, nappy area affected, can affect knees when crawling

Question 10

Early Childhood Eczema

Answer 10

From 18-24 moves to flexures
Neck often involved
‘Dirty Neck’ appearance
Demi-Morgan (Infra orbital) folds

Question 11

Adult type Eczema

Answer 11

Increased lichenification
Flexures and hands
Pitting and ridging of nail

Question 12

Drug induced photosensitivity

Answer 12

Thiazide Diuretics
Tetracyclines
NSAIDS

Question 13

Photocontact dermatitis

Answer 13

Phototoxic chemicals: plants, vegetables, fruit, fragrances in cosmetics

Question 14

Steps to Dermatology Examination

Answer 14

1. Inspect
2. Describe
3. Palpate
4. Systematic check

Question 15

Investigations for Eczema

Answer 15

• IgE/RAST

- Patch tests

Question 16

Indications for Patch testing

Answer 16

Recent onset eczema in older child or adult
Odd distribution or localised pattern
Suggestive history
Poor response to treatment
Altered disease behaviour

Question 17

First line treatment for Eczema

Answer 17

Emoillients: topical, soap substitute, bath additives
Topical steroids
Topical immunomodulators (calcineuriin inhibitors)

Question 18

Steroid ladder

Answer 18

• Mild e.g. Hydrocortisone 1% synalar 1:10
• Moderately potent e.g. Eumovate, modrasone
• Potent e.g. Betnovate, mometosone, Locoid, synalar
• Very Potent e.g Dermovate

Question 19

What’s a Steroid ‘fingertip unit’

Answer 19

One FTU covers area of palm of two hands

1FTU = 0.5g

Question 20

Second line treatment for Eczema

Answer 20

Antibiotics
Oral Steroids
Phototherapy
Immunosuppresants: Methotrexate, Azathioprine, Ciclosporin, Mycophenolate Motefil