eczema

Question 1

other name for eczema?

Answer 1

atopic dermatitis

Question 2

what is eczema?

Answer 2

inflammatory skin condition

Question 3

which 2 types of factors can induce eczema?

Answer 3

exogenous - external

endogenous - internal

Question 4

which areas of the body are commonly affected?

Answer 4

flexural areas

Question 5

give examples of flexural areas of the body?

Answer 5

backs of the knees
armpits/axilla
elbows
groin

Question 6

what is the definition (as well as the qualifying diagnosis) of atopic eczema?

Answer 6

an itchy skin condition in last 12 months PLUS 3 of the following -

onset < 2yrs
history of flexural involvement
history of general dry skin
history of other atopic disease

Question 7

describe 2 genetic aspects of the pathogenesis behind atopic eczema?

Answer 7

filaggrin gene dysfunction

atopic FH - eczema, asthma, hay fever etc.

Question 8

key role of filaggrin gene?

Answer 8

plays an important role in the skin’s barrier function, by bringing together structural proteins in the outermost skin cells to form tight bundles, flattening and strengthening the cells to create a strong barrier.

Question 9

name 3 other factors of the pathogenesis of atopic eczema?

Answer 9

epidermal barrier dysfunction

environmental factors

immune system dysregulation

Question 10

what is spongiosis?

Answer 10

intercellular oedema within the epidermis

Question 11

what is acanthosis?

Answer 11

thickening of the epidermis

Question 12

describe clinical features of atopic eczema (a+c)?

Answer 12

itch (KEY)
location - flexures, neck, eyelids, face, hands, feet,
NOT on nappy area

Question 13

acute changes in atopic eczema?

Answer 13

erythema 
scale 
papules
vesicles
exudate
crusting

Question 14

chronic changes in atopic eczema?

Answer 14

lichenification
plaques
fissuring

Question 15

name 3 types of exogenous eczema?

Answer 15

contact dermatitis
lichen simplex
photoallergic eczema

Question 16

name 3 types of endogenous eczema?

Answer 16

discoid
venous
seborrhoeic dermatitis

Question 17

which type of eczema is atopic?

Answer 17

endogenous

Question 18

what is allergic contact dermatitis due to?

Answer 18

type 4 hypersensitivity

Question 19

how long for reaction of allergic contact dermatitis?

Answer 19

48-72hrs

delayed hypersensitivity

Question 20

name another form of contact dermatitis?

Answer 20

irritant contact dermatitis

Question 21

what causes injury to the skin in cases of irritant contact dermatitis?

Answer 21

friction

environmental factors

Question 22

environmental factors causing irritant contact dermatitis?

Answer 22

cold
over-exposure to water
chemicals - acids, alkalis, detergents, solvents

Question 23

name 3 occupations with an increased chance of developing irritant contact dermatitis?

Answer 23

hairdressers
cleaners
NHS staff

Question 24

describe patch testing?

Answer 24

potential allergens applied to patients, using a standard series

Question 25

routine of patch testing?

Answer 25

applied Monday, removed Wednesday, reassessed Friday

Question 26

describe seborrhoeic dermatitis infants?

Answer 26

distinctive pattern - predilection for scalp, proximal flexures <6months usually

Question 27

describe seborrhoeic eczema adults?

Answer 27

chronic dermatitis | Malassezia yeast increased in the scaly epidermis of dandruff and seborrehoic dermatitis

Question 28

presentation of seborrhoeic eczema adults?

Answer 28

red, sharply marginated lesions covered with greasy looking scales distinctive distribution - scalp, face, upper trunk

Question 29

what is a precursor for seborrhoeic eczema?

Answer 29

dandruff - can progress through redness and irritation

Question 30

treatment for seborrhoeic eczema?

Answer 30

topical anti-yeast - Ketoconazole

Question 31

consideration needed for severe seborrhoeic eczema?

Answer 31

HIV test

Question 32

how does discoid eczema present and where does it develop?

Answer 32

circular plaques of eczema | develops at sites of trauma/irritation

Question 33

presentation of Pompholyx/vesicular eczema?

Answer 33

intensely itchy palms and soles, sudden onset of crops of vesicles more common <40yrs

Question 34

resolution for Pompholyx/vesicular eczema?

Answer 34

includes desquamation

Question 35

what is desquamation?

Answer 35

skin peeling

Question 36

describe presentation of asteatotic eczema?

Answer 36

very dry skin, with cracked and scaly appearance shins most commonly affected

Question 37

2 causes of Asteatotic eczema?

Answer 37

heat (climate) | excessive washing/soaps

Question 38

what is venous eczema?

Answer 38

stasis/ varicose eczema

Question 39

signs of venous eczema?

Answer 39

increased venous pressure oedema ankle+lower limb involved

Question 40

treatment of venous eczema?

Answer 40

compression stockings (oedema)

Question 41

presentation of eczema herpeticum?

Answer 41

disseminated viral infection - ``` fever malaise itchy clusters of blisters herpes simplex 1+2 swollen lymph glands ```

Question 42

treatments for eczema herpeticum?

Answer 42

admission antivirals 2y bacterial infection considered

Question 43

treatment of eczema?

Answer 43

``` patient education avoid exacerbating factors emollients soap subs intermittent topical steroids antihistamines/ antimicrobials Calcineurin Inhibitors ```

Question 44

describe 3 types of emollients?

Answer 44

ointment - greasy but effective creams - lighter lotions - watery

Question 45

topical steroids - name 2 used?

Answer 45

hydrocortisone | bethamethasone

Question 46

compare potency of these 2 topical steroids?

Answer 46

hydrocortisone - low | bethamethasone - potent

Question 47

name 2 Calcineurin Inhibitors?

Answer 47

Topical - Pimecrolimus Tacrolimus

Question 48

what is Pimecrolimus?

Answer 48

topical steroid-FREE med with immune-modulating and anti-inflammatory properties

Question 49

treatments of severe eczema?

Answer 49

UV light | immunosuppression

Question 50

immunosuppression agents used as treatments of severe eczema?

Answer 50

Azathioprine Ciclosporin Mycophenolate mofetil Methotrexate

Question 51

what is dupilumab?

Answer 51

1st biologic for eczema patients - IL-4 and IL-13 inhibitor

Question 52

what is crisaborole?

Answer 52

topical PDE-4 inhibitor used to treat eczema