eczema Flashcards
What is eczema?
chronic atopic conditions caused by defects in normal continuity of the skin barrier leading to inflammation of the skin
Where does eczema occur?
presents in infancy with dry, red, itchy and sore patches of skin over flexor surfaces and on face and neck
pathophysiology of eczema
defects in barrier provide entrance for irritants, microbes and allergens
cause immune response
Maintenance management
emollients after washing and before bed
soap substitutes
avoiding triggers
what are emollients?
thick and greasy - can be used in the bath aswell
possible triggers
temperature diet washing powders cleaning products stress
treating flares
thicker emollients topical steroids wet wraps treat any infections rarely IV antibiotics or oral steroids
specialist treatments
topical tacrolimus
phototherapy
systemic immunosuppressants eg CCS, methotrexate and azathioprine
zinc impregnated bandages
examples of thin cream emollients
E45, aveeno, diprobase
examples of thick, greasy emollients
50:50 ointment
other ointments
rule for topical steroids
use weakest steroid for shortest period
topical steroids side effects
thinning of skin, bruising, stretch marks and enlarged blood vessels (telangiectasia)
areas not for topical steroids
not on face, eyes or genitals
steroid ladder (1–>4)
Hydrocortisone 0.5%, 1% and 2.5%
eumovate
betnovate (betamethasone)
dermovate
common cause of skin infection
staph aureus
treating skin infection with eczema
oral antibiotics - flucloxacillin
eczema herpeticum
viral skin infection caused by HSV1 or VZV
most common causative organism eczema herpeticum and origin
HSv1 from a cold sore (patient or close contact)
presentation of eczema herpeticum
widespread painful, vesicular rash with fever, lethargy, irritability or reduced oral intake
usually LN
managing eczema herpeticum
viral swabs of vesicles
aciclovir
complications of eczema herpeticum
life threatening especially if immunocompromised
bacterial superinfection can occur
