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Dermatology > Eczema > Flashcards

Eczema Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the classical signs of eczema

A

erythema
skin scaling
skin dryness
usually in flexural areas

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2
Q

what may the acute form of eczema have

A

vesicles/blisters

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3
Q

what occurs in more serious eczema

A

skin fissures

lichenification

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4
Q

whats the pathology of acute eczema

A

dermal vessel dilation causing epidermoid oedema and separation of keratinocytes (spongiosis) with inflammation of the dermis and epidermis

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5
Q

whats the pathology of subacute eczema

A

less spongiosis (keratinocyte separation)
thickening of epidermis (acanthosis)
increased keratin production
hyperkeratosis and parakeratosis

all this leds to more scaling

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6
Q

what is the pathology of chronic eczema

A

marked acanthosis, hyperkeratosis and parakeratosis

persistent vessel dilation and inflammation

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7
Q

what are types of endogenous eczema

A

atopic

serborrhoeic

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8
Q

what are types of exogenous eczema

A 
irritant 
infective 
allergic contact
asteatotic
gravitational/varicose
discoid
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9
Q

what are two broad classifications of eczema

A

exogenous

endogenous

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10
Q

where is irritant contact dermatitis most common

A

dorsum of hand and in the finger webs

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11
Q

what is the reason for irritant contact dermatitis

A

irritants destroying skin barriers

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12
Q

what occupations are at increased risk for irritant contact dermatitis

A 
chefs
hairdressers
housewives
cleaners
nurses
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13
Q

what kind of reaction is allergic contact dermatitis

A

type 4 cell mediated reaction

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14
Q

what are common sources for allergic contact dermatitis

A 
nickel jewellry
hair dye 
plants
topical medications
fragrance 
occupational
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15
Q

how do you confirm an allergic contact dermatitis

A

patch/spot testing

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16
Q

how long is a patch left on during patch testing

A

48 hours

17
Q

how are results collected for patch testing

A

area is examined 10 minutes after removing the patch, then 96 hours (4 days) after that

0 = no reaction 
\+/- = doubtful reaction 
\+  = weak reaction (erythema)
\++ = strong reaction (erythema,odema,vesicles) 
\+++ = extreme reaction (erythema + bullous) 
IR = irritatn reaction (varicble but well circumscribed with a glazed appearance)
18
Q

when does atopic eczema come on most commonly

A

<2 years old onset

19
Q

how does atopic eczema change with age

A

decrease in severity with age

50% grow out of it by 2, 80% by adolescence

20
Q

what is discoid eczema

A

well demarcated discrete plaques that can occur at any site at any age

21
Q

what is discoid eczema most commonly associated with

A

infection

22
Q

what is varicose eczema

A

eczema occuring around varicose veins/chronic venous disease

23
Q

what is a helpful treatment adjunct for varicose eczema

A

compression

24
Q

what is asteatotic eczema

A

a decrease in skin fat content (usually in elderly) leading to ‘crazy paving’ looking dry skin

25
Q

whats the treatment for asteatotic eczema

A

topical steroids with long term emmolients

advice to now over-wash as it dries skin out

26
Q

what is pompholytic eczema

A

eczema provoked by heat/emotion/nickel allergy

27
Q

what are features of pompholytic eczema

A

recurrent bouts of vesicles/arge blisters on palms, finggers and soles lasting for a few weeks at itrregular intervals

28
Q

what are common complications of pompholytic eczema

A

secondary infection

lymphangitis

29
Q

what are some useful treatments for acute eczema in a hospital setting

A

antibiotics if bacterial infection suspected

aluminium acetate/potassium permanganate soaks with very potent corticosteroids is also helpful

30
Q

who is more likely to get seborrhoeic eczema

A

middle aged adults

alcoholics

31
Q

what superinfection is seborrheic eczema associated with

A

pitryosporum yeast species

32
Q

what is the first line management for atopic eczema

A

avoid exacerbating facotr s
PRN emmolient
active eczema areas (erythematous/painful areas) should be treated with topical steroids

33
Q

what form are steroids given in for eczema and why

A

ointments, as they have greater efficacy and decreased chance of allergy than creams

34
Q

whats the reccomended application routine for steroids

A

1-2 times a day in bursts, with days off inbetween

35
Q

what are secondary treatment options for atopic eczema

A 
topical immunomodulators (tacrolimus) 
bandagin/wet wraps 
systemic treatment (UV light, oral pred, cyclosporine, azathioprine)
36
Q

what are the main side effects of topical steroids

A 
telangeictasa 
perioral dermatitis
eye prpblems
striae
glaucoma
cataracts
pigmentation

Dermatology (12 decks)

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