Eczema and Papulosquamous Dz

Question 1

Excematous lesion descroption

Answer 1

Scaling
Crusting
Serous oozing

Question 2

Atopic Dermatitis

Answer 2

AKA Eczema
Common (11% of pop)
Most cases by age 5-7
40% clear by adulthood

Question 3

Atopic Dermatitis s/s

Answer 3

Pruritis is hallmark
Scratching leads to skin change
Lesions may ooze, crust and become purulent

Question 4

Atopic Dermatitis Tx

Answer 4

Avoid heat, low humidity
Treat stress, anxiety
Antihistamines
Hydration
Topical steroids (hydrocortisone)

Question 5

Doxepin and Vistaril

Answer 5

Antidepressants w/ antihistamine SE

Used for atopic dermatitis

Question 6

Topical Calcineurin inhibitors

Answer 6

Used instead of medium potency topical steroids
Less SE
Tacrolimus, Pimecrolimus
2nd line because of BBW

Question 7

Topical Calcineurin inhibitors Black box warning

Answer 7

May increase risk of skin CA and lymphoma

Question 8

Nummular eczema

Answer 8

Atopic dermatitis that is described as coin shaped lesions
Same tx as atopic derm.
Usually on trunk and LE

Question 9

Lichen simplex chronicus

Answer 9

Chronic eczematous changes from scratching

Question 10

Dyshydrotic Eczema

Answer 10

Vesicular eruption of hands and feet.

Very itchy, blisters, deep

Question 11

Dyshydrotic Eczema tx

Answer 11

High potency topical steroids

Hydration of skin w/ emollient cream

Question 12

COntact dermatitis

Answer 12

Caused by an allergy and direct contact

Question 13

Tx of plant based contact dermatitis

Answer 13

Oatmeal bath, cool, wet compress
Calamine lotion, Zanfel soap
Antihistamines for sedation
Clobetasol steroid cream

Question 14

Systemic steroids are needed for contact dermatitis if…

Answer 14

> 10% BSA
or genital or face involvement
Use Medrol dose pack

Question 15

Diaper Dermatitis

Answer 15

Erythema in diaper area

Can involve candidiasis infxn

Question 16

If diaper rash is mostly in skin folds and there are satellite lesions…

Answer 16

It is most likely candidiasis

Question 17

Diaper rash tx

Answer 17

w/o yeast: frequent diaper change, vasoline

w/ yeast: all of above plus topical atifungal

Question 18

Perioral dermatitis

Answer 18

1-2 mm clustered papules
Associated w/ topical steroid use
Vermillion border is spared

Question 19

Perioral dermatitis tx

Answer 19

May resolve on its own
1st line: Topical calcineurin inhibitor
or
Topical erythromycin
For severe:  systemic tetracycline or doxycycline

Question 20

Seborrheic Dermatitis

Answer 20

May be widespread in HIV or parkinsons
Erythematous scaling patched in scalp, face and trunk
Caused by saphrophyte infxn

Question 21

Seborrheic Dermatitis presentation

Answer 21

Erythema (red or pink)
Swollen and greasy
Pruritis
White or yellowish scales

Question 22

Seborrheic Dermatitis Tx

Answer 22

Antiproliferative shampoo (head and shoulders)
Antifungal shampoo

Question 23

Lichen planus

Answer 23

Uncommon disorder of middle aged adults

May effect skin, mouth, genitals, scalp, nails, esophagus

Question 24

Lichen planus s/s

Answer 24

Wickman striae

Intense prutitis

Question 25

Lichen planus tx

Answer 25

High-potency topical steroid

Question 26

Stasis dermatitis

Answer 26

Occurs from blood pooling due to venous insufficiency
Hemosiderin from vessels stains skin
Tx with stockings and wound care

Question 27

Pityriasis Rosea

Answer 27

Likely viral rash
First sign is a herald patch
Not contagious
Oval lesions