Eczema Flashcards

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1
Q

Define

A

A pruritic papulovesicular skin reaction to endogenous or exogenous agents

→ Chronic, relapsing, inflammatory skin condition characterised by an itchy red rash

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2
Q

Causes/ risk factors

A

There are lots of types because there are many different triggers

Exogenous

  • Irritants (e.g. nappy rash)
  • Contact (delayed type 4 hypersensitivity reaction to an allergen)
  • Atopic

Endogenous

  • Atopic
  • Seborrhoeic
  • Pompholyx (a type of eczema that affects the hands and feet)
  • Varicose
  • Lichen simplex

Varicose - due to increased venous pressure in lower limbs

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3
Q

Epidemiology

A

Contact - prevalence: 4%

Atopic - onset in first year of life, childhood incidence: 10-20%

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4
Q

Symptoms

A

Itching

Heat

Tenderness

Redness

Weeping

Crusting

Ask about occupational exposure to irritants 9eg.. Bleach)

Ask about personal/family history of atopy (e.g. asthma, hay fever)

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5
Q

Sign

A

Acute

  • Poorly demarcated erythematous oedematous dry scaling patches
  • Papules
  • Vesicles with exudation and crusting
  • Excoriation marks

Chronic

  • Thickened epidermis
  • Skin lichenification
  • Fissures
  • Change in pigmentation

Based on type of eczema

  • Atopic - mainly affects face and flexures
  • Seborrhoeic - yellow greasy scales on erythematous plaques. Commonly found on eyebrows, scalp, presternal area
  • Pompholyx - vesiculobullous eruption on palms and soles
  • Varicose - associated with marked varicose veins
  • Nummular - coin shaped, on legs and trunk
  • Asteatotic - dry, crazy paring pattern
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6
Q

Investigations

A

Contact Eczema

  • Skin patch testing - a disc containing allergens is diluted and applied on the skin for 48 hrs. It is positive if it causes a red raised lesion

Atopic Eczema

  • Lab testing e.g. IgE levels
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