Eczema and dermatitis Flashcards
T/F
Exogenous eczema means spongiotic dermatoses caused by things contacting the skin
True
mainly treat by removing the trigger
What are the causes of exogenous eczemas?
Irritant contact dermatitis Allergic contact dermatitis Photoallergic contact dermatitis Phototoxic contact dermatitis inc phytophotodermatitis Eczematous PMLE Dermatophytide (Id reaction) Infectious eczema e.g. Discoid Post-traumatic eczema
T/F
phototoxic drug reactions are a type of Exogenous eczema
False
phototoxic drug reactions are sunburn like rather than eczematous if due to systemic drugs
Phototoxic contact dermatitis is an exogenous eczema
T/F
generalized endogenous eczema is a valid diagnosis in elderly people
True
If doesnt fit a recognised type and no exogenous cause found
T/F
All eczematous dermatoses have acute, subacute and chronic lesions
False
eczema does but many other have single charcteristic appearances which are often acute
e.g. pompholyx, phytophotodermatitis
T/F
Autoeczematization means the same as dermatophytide or ‘Id’ reaction
False
Autoeczematization is secondary dissemination of eczema
‘Id reaction’ or ‘dermatophytide’ etc is used if the primary site is infection rather than eczema
Whic type of eczema most commonly causes autoeczematization?
stasis dermatitis
Also, regardless of cause, more likely if primary eczema site is on feet or legs
T/F
Typical for hand eczemas to spread to feet and vice versa
True
autoeczematization
T/F
Autoeczematization only occurs in long established eczemas
False
Eczema may have been present for any duration of time before spread
T/F
Dissemination (autoeczematization) often follows a local flare
True
How does autoeczematization present?
Often the eruption is symmetrical and striking
Starts as oedematous papules or papulovesicles or sometimes macules or wheals – soon become eczematous lesions
Can become generalized, can become erythroderma
T/F
Autoeczematization responds to Rx of the primary site but worsens if primary site worsens
True
What is meant by ‘conditioned hyperirritability’?
Skin away from the eczema site is more prone to flare up from irritants than normal skin
o Can be the cause for high proportion of irritant reactions to patch tests and the ‘angry back’ syndrome
o Unclear if this is the real cause of autoeczematisation reactions
T/F
Eczematous (spongiotic) drug reactions are a type of Exogenous eczema
False
Classified as endogenous as not due to something contacting the skin
What are the clinical appearances of eczematous drug eruptions?
Localized eczema Generalized eczema (AD-like) seb derm-like Erythroderma Pompholyx (esp IVIg) Baboon syndrome subtype of ‘systemic contact-type dermatitis (medicamentosa)’
T/F
SDRIFE is the same thing as Baboon syndrome as a presentation of systemic contact dermatitis
False
Look the same and both called Baboon syndrome but Symmetrical Drug-Related Intertriginous and Flexural Exanthema (SDRIFE) is a clinical pattern of drug reaction caused by a normal oral drug exposure not oral ingestion of a contact allergen
T/F
Phenytoin is a classic cause of a widespread eczematous eruption which can involve flexures resembling atopic dermatitis
False
this is Carbamazepine
T/F
IVIg can cause cheiropompholyx
True
What is systemic contact-type dermatitis (medicamentosa)?
AKA ‘systemically reactivated contact dermatitis’ or ‘systemic contact dermatitis’
whereby a rash is precipitated by ingestion of a drug or compound to which the patient has a contact allergy due to prior physical contact of the same or a related compound
Can present as Baboon syndrome or another clinical pattern
What are the causes of systemic contact dermatitis?
Many
People sensitive to balsam of Peru can get rcns to ingested Cinnamon, vanilla, cloves or inhalation of tincture of benzoin
Pts sensitized to nickel, chromium, parabens, propylene glycol or sorbic acid can get rcns when these are ingested
Which allergens are associated with the Baboon syndrome presentation of systemic conatct dermatitis?
Nickel, chromium, balsam of Peru
T/F
systemic contact dermatitis often first or most severely affects site of prior ACD
True
T/F
systemic contact dermatitis is often symmetrical
True
T/F
Contact sensitization to neomycin can result in systemic contact dermatitis when gentamicin is given
True
also if given systemic neomycin