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Dermatology > eczema > Flashcards

eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

other name for eczema?

A

atopic dermatitis

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2
Q

what is eczema?

A

inflammatory skin condition

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3
Q

which 2 types of factors can induce eczema?

A

exogenous - external

endogenous - internal

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4
Q

which areas of the body are commonly affected?

A

flexural areas

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5
Q

give examples of flexural areas of the body?

A

backs of the knees
armpits/axilla
elbows
groin

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6
Q

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

A

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

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7
Q

describe 2 genetic aspects of the pathogenesis behind atopic eczema?

A

filaggrin gene dysfunction

atopic FH - eczema, asthma, hay fever etc.

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8
Q

key role of filaggrin gene?

A

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.

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9
Q

name 3 other factors of the pathogenesis of atopic eczema?

A

epidermal barrier dysfunction

environmental factors

immune system dysregulation

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10
Q

what is spongiosis?

A

intercellular oedema within the epidermis

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11
Q

what is acanthosis?

A

thickening of the epidermis

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12
Q

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

A

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

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13
Q

acute changes in atopic eczema?

A 
erythema 
scale 
papules
vesicles
exudate
crusting
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14
Q

chronic changes in atopic eczema?

A

lichenification
plaques
fissuring

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15
Q

name 3 types of exogenous eczema?

A

contact dermatitis
lichen simplex
photoallergic eczema

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16
Q

name 3 types of endogenous eczema?

A

discoid
venous
seborrhoeic dermatitis

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17
Q

which type of eczema is atopic?

A

endogenous

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18
Q

what is allergic contact dermatitis due to?

A

type 4 hypersensitivity

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19
Q

how long for reaction of allergic contact dermatitis?

A

48-72hrs

delayed hypersensitivity

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20
Q

name another form of contact dermatitis?

A

irritant contact dermatitis

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21
Q

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

A

friction

environmental factors

22
Q

environmental factors causing irritant contact dermatitis?

A

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

23
Q

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

A

hairdressers
cleaners
NHS staff

24
Q

describe patch testing?

A

potential allergens applied to patients, using a standard series

25
Q

routine of patch testing?

A

applied Monday,
removed Wednesday,
reassessed Friday

26
Q

describe seborrhoeic dermatitis infants?

A

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

27
Q

describe seborrhoeic eczema adults?

A

chronic dermatitis

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

28
Q

presentation of seborrhoeic eczema adults?

A

red, sharply marginated lesions covered with greasy looking scales

distinctive distribution - scalp, face, upper trunk

29
Q

what is a precursor for seborrhoeic eczema?

A

dandruff - can progress through redness and irritation

30
Q

treatment for seborrhoeic eczema?

A

topical anti-yeast - Ketoconazole

31
Q

consideration needed for severe seborrhoeic eczema?

A

HIV test

32
Q

how does discoid eczema present and where does it develop?

A

circular plaques of eczema

develops at sites of trauma/irritation

33
Q

presentation of Pompholyx/vesicular eczema?

A

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

34
Q

resolution for Pompholyx/vesicular eczema?

A

includes desquamation

35
Q

what is desquamation?

A

skin peeling

36
Q

describe presentation of asteatotic eczema?

A

very dry skin, with cracked and scaly appearance

shins most commonly affected

37
Q

2 causes of Asteatotic eczema?

A

heat (climate)

excessive washing/soaps

38
Q

what is venous eczema?

A

stasis/ varicose eczema

39
Q

signs of venous eczema?

A

increased venous pressure
oedema
ankle+lower limb involved

40
Q

treatment of venous eczema?

A

compression stockings (oedema)

41
Q

presentation of eczema herpeticum?

A

disseminated viral infection -

fever
malaise 
itchy clusters of blisters 
herpes simplex 1+2
swollen lymph glands
42
Q

treatments for eczema herpeticum?

A

admission
antivirals
2y bacterial infection considered

43
Q

treatment of eczema?

A 
patient education 
avoid exacerbating factors
emollients 
soap subs
intermittent topical steroids
antihistamines/ antimicrobials 
Calcineurin Inhibitors
44
Q

describe 3 types of emollients?

A

ointment - greasy but effective
creams - lighter
lotions - watery

45
Q

topical steroids - name 2 used?

A

hydrocortisone

bethamethasone

46
Q

compare potency of these 2 topical steroids?

A

hydrocortisone - low

bethamethasone - potent

47
Q

name 2 Calcineurin Inhibitors?

A

Topical -
Pimecrolimus
Tacrolimus

48
Q

what is Pimecrolimus?

A

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

49
Q

treatments of severe eczema?

A

UV light

immunosuppression

50
Q

immunosuppression agents used as treatments of severe eczema?

A

Azathioprine
Ciclosporin
Mycophenolate mofetil
Methotrexate

51
Q

what is dupilumab?

A

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

52
Q

what is crisaborole?

A

topical PDE-4 inhibitor used to treat eczema

Dermatology (8 decks)

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