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eczema/dermatitis Flashcards

1
Q

What are the most common types of eczema?

A
  • contact dermatitis - atopic dermatitis - seborrheic dermatitis - pompholyx - nummular eczema - lichem simplex chronicus
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2
Q

type of eczema that can be acute or chronic and is often vesicular and oozing with positive history of contact

A

contact dermatitis

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3
Q

acute, dry, scaly, itchy skin at joints

typically has allergic or family history

A

atopic dermatitis

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4
Q

diffuse, yellowish oily patches near nose or scalp that are less itchy

A

seborrheic dermatitis (AKA dandruff)

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5
Q

acute, recurring, pruritic, weeping vesicles on hands and feet

A

pompholyx/ dyshidrosis eczema

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6
Q

pruritic papulovesicular or scaly coin-shaped lesions

A

nummular eczema

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7
Q

single dry, thick scaly lesion with a chronic itch-scratch cycle

A

Lichen Simplex Chronicus

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8
Q

What stage of eczema/dermatitis is characterized by well demarcated plaques of erythema and edema with vesicles, blisters and intense itch?

A

acute

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9
Q

What stage of eczema/dermatitis is characterized by redness, scaling, fissuring, parched appearance, scaled appearance, slight to moderate itch, pain, stinging and burning?

A

subacute

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10
Q

What stage of eczema/dermatitis is characterized by thickened skin, skin lines accentuated (lichenified), excoriations, fissuring and moderate to intense itch

A

chronic

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11
Q

80% of all dermatitis is _____ dermatitis and is most common on _____.

A

irritant contact

hands

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12
Q

What are some preventative measures that can be taken for irritant contact dermatitis?

A
  • avoid irritant
  • rinse if there is exposure
  • use barrier creams such as petrolatum
  • change of job may be necessary
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13
Q

What are some topical treatments for irritant contact dermatitis?

A
  • powder (baby powder)
  • ointment (calendula, A&D, Comfrey)
  • wet soaks containing tap water, saline, colloidal oatmeal
  • wet soaks containing Burow’s (aluminum acetate) solution
  • honey, olive oil, beeswax mixture
  • corticosteroids
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14
Q

What are oral treatments for severe irritant contact dermatitis?

A

systemic corticosteroids (prednisone)

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15
Q

What is the typical course of irritant contact dermatitis?

A
  • usually heals within 2 weeks, 6 for chronic cases
  • occupational exposures only have 1/3 complete remission
  • atopic individuals have poor prognosis
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16
Q

dermatitis at site of contact (watchband, earrings) that appears 24-48 hours after contact

A

allergic contact dermatitis

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17
Q

Allergic dermatitis is what class of immune response?

A

type IV (delayed) hypersensitivity

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18
Q

what are the top 10 allergens that can cause dermatitis?

A
  • nickel sulfate
  • neomycin sulfate
  • balsam of peru
  • fragrance mix
  • thimerisol
  • sodium gold thiosulfate
  • formaldehyde
  • quaternium - 15
  • cobalt chloride
  • bacitracin
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19
Q

sensitization and dermatitis 7-10 days after exposure fo toxicodendron haptens

A

allergic contact dermatitis due to plants (APD)

* poison oak/ivy

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20
Q

What are some preventative measures against poison oak/ivy?

A
  • avoid contact
  • wash entire body with copious water after exposure
  • barrier creams
  • wash clothing and pets that were exposed
  • trim fingernails
  • avoid soap as it can spread resin
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21
Q

What are some topical treatments for allergic dermatitis due to plants?

A
  • calendula lotion
  • calamine (zinc and ferrous oxide)
  • Burow’s solution (aluminum acetate)
  • EtOH, Comfrey, mugwart and seasalt
  • oatmeal, starch or vinegar bath
  • aloe gel
  • glucocorticoids
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22
Q

When are oral steroids indicated for poison oak/ivy exposure and dermatitis?

A

if greater than 25% of the body surface is affected

if there is severe itching or blistering

if there is significant involvement of the face, hands or genitals

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23
Q

What is the normal course for poison oak?

A
  • rash begins 24-36 hours after exposure
  • lasts 3-4 days, clears within next 5 days
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24
Q

inflammation of the dermis and epidermis with unknown cause

A

atopic dermatitis

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25
What is the prevalence of atopic dermatitis in the general population?
7-15% (increasing incidence in Western World
26
What are some key factors for the pathogenesis of atopic dermatitis?
- terrain - genetic susceptibility or abnormality - immune dysfunction - epidermal barrier dysfunction - IgE mediated hypersensitivity - increased cAMP levels - defect in delts-6-desaturase - dry skin in childhood
27
What are the 4 major features of atopic dermatitis, 3 out of 4 of which should be present for diagnosis?
- pruritis - typical morphology and distribution - chronic relapsing dermatitis - personal or family history of atopic dermatitis
28
What are other minor features of atopic dermatitis that may be present?
- cataracts - caonjunctivitis - infraorbital folds (dennie-morgan lines) - keratosis pilaris (chicken skin) - palm creases - keratoconus - food intolerance - etc.
29
What are the stages of atopic dermatitis?
- infantile (2 mos - 2 years) - childhood (2 -12 years) - adult (12+ years)
30
In the infantile stage of atopic dermatitis, what areas of the body are involved?
scalp, face, extensor surface
31
In the childhood stage of atopic dermatitis, what areas of the body are affected?
antecubital and popliteal fossae, posterior neck
32
red, finely vesicular, oozing, crusting and pus with increased likelihood of secondary infection is descriptive of what stage of atopic dermatitis?
infantile atopic dermatitis
33
erythema, papules, scaling, licenification, patches of hypopigmentation and hair loss are descriptive of what stage of atopic dermatitis?
childhood atopic dermatitis
34
many children with atopic dermatitis will develop what other conditions?
allergic rhinitis asthma
35
In the adult stage of atopic dermatitis, what part of the body is affected?
same as childhood but it extends to the neck, upper chest, hands and feet
36
marked drying-resembling ichthyosis, intense pruritis, infraorbital fold (dennie-morgan) and thinning lateral eyebrows is descriptive of what stage of atopic dermatitis
adult atopic dermatitis
37
What condition is triggered by temp changes and sweating? And is worse in the winter and excessive bathing?
Atopic dermatitis
38
What is the treatment for atopic dermatitis
Topical immunosuppresives calcineurin inhibitors: cyclosporine systemic steroids either oral (prednisone) or intramuscularly (trimcinolone)
39
What is a natural topical application for atopic dermatitis?
Honey, beeswax, olive oil (1:1:1)
40
Necklaces, buckles, clips, buttons can all irritate the skin and cause
Allergic contact dermatitis
41
What diet modifications might be suggested for dermatitis?
Avoid eggs, peanuts, milk, fish, soy, wheat Add Lactobacillus, Glutamine-enriched food, oral cholecalciferol (Vit D)
42
What herbs might be suggested for AD?
Coleus forskohlii, licorice, ginkgo, oolong tea green tea, grape seed extract, iris, taraxacum, rumex, phytolacca, turmeric, rhubarb
43
What is characterized by yellowish oily patches near nose and scalp?
Seborrheic dermatitis More images: Left is cradle cap and Right is periorbital S.D. ![]()
44
Who is affected by seborrheic dermatitis?
Males more than females Infancy and 20-50 yo
45
What locations are common for seborrheic dermatitis
Scalp, eyebrows, eyelids, nasolabial fold, paranasal area, ears, sternum, inframammary fold, axilla, pubic area, gluteal and inguinal fold, umbilicus ![]()
46
What is the treatment for infantile seborrheic dermatitis
Anti-inflammatory/elimination/detox diet orally: zinc, b vitamins, niacin, biotin, omega fatty acids topically: gentle shampoo, emollients like olive oil, antifungals like bifonazole 1% shampoo, corticosteroids like hydrocortizone cream
47
Seborrheic dermatitis treatment for adults
48
Topical CAM option for seborrheic dermatitis
49
What is acute, chronic, recurrent dermatitis of the hands and soles that affects F\>M?
Pompholyx/dyshidrotic eczema “Pompholyx” = bubble
50
What age is affected most by Pompholyx/dyshidrotic eczema
12-40 yo
51
What is characterized by sudden deep-seated pruritic, clear “tapioca-like” vesicles on palms and sides of fingers that later lead to scaling fissures and lichenification?
Pompholyx/dyshidrotic eczema Define: lichenified skin means skin that has become thickened and leathery. This often results from continuously rubbing or scratching the skin. Photo: 2-4 weeks complications may occur with 2˚ infections
52
Sudden onset tapioca-like vesicles unknown etiology
53
What are treatment options for Pompholyx/dyshidrotic eczema
Antiinflammatory diet wet astringent compress with dilute vinegar heliotherapy acupuncture, homeopathy, herbal, meditation topical or intralesional trimcinolone prednisone, antibiotics with infection
54
What is the treatment for this condition that affects females more than males and is characterized by thick plaques (usually 1 lesion) with severe pruritus and lasts indefinitely and recurs frequently?
55
What are CAM treatments for lichen simplex chronicus (LSC)?
Occlusive barrier-unna and dome paste boot tranquilizer acupuncture transcutaneous electrical nerve stimulation
56
What are Rx treatments for Lichen simplex chronicus
Glucocorticoid gauze dressing intralesional trimcinolone lidocane hydroxyzine antihistamines
57
What are complications to Lichen simplex chronicus?
58
What condition is characterized by common, chronic, coin-shaped plaques?
Nummular eczema (or numular dermatitis) “Nummular” = coin-shaped
59
Where is nummular eczema commonly located
60
How long does nummular eczema last?
61
What is the condition that is characterized by an initial onset of closely grouped, small vesicles and papules that coalesce into plaques where the itching is moderate to severe?
Nummular eczema
62
An itchy, dyhidrotic-like vesicular eruption on the fingers, forearms, thighs, legs, trunk
Id reaction
63
Treatment for Id reaction?
Prednisone to help control pruritus
64
Characterized by cracked porcelain pattern. Erythema, inflammation and scaling with pruritus.
Asteatotic dermatitis
65
Mgmt/treatment of asteatotic dermatitis?
66
Condition that occurs from venous return failure and increased presssure of capillaries where multiple progressive dermatological changes occur
Stasis Dermatitis
67
Locations of Stasis Dermatitis
68
Stasis Dermatitis is associated with
Edema, varicose and dilated veins
69
Mgmt/treatment of Stasis Dermatitis
Improve venous return through cool water dressing, cool water walking, compression stockings, anti-inflammatory diet, herbs (ginkgo, aesculus, centella) bland emollients topical steroids oral antihistamines vein stripping or sclerotherapy
70
Associated with chronic venous insufficiency from venous return failure and increased capillary pressure. Mgmt/tx = improve venous return
71
Characterized by progressive complication of CVI (chronic venous insufficiency). Non-healing shallow painful ulcer in the lower extremities above the ankle or at the malleolus.
Venous leg ulcers
72
What are Tx for venous leg ulcers?
Same as stasis dermatitis Compression therapy, leg elevation Supervised exercises
73
Nonhealing shallow painful ulcer in LE above ankle or at malleolus. Sharply demarcated ulcer surrounded by atrophied Blanche. Pale plaques of scar tissue surrounded by stasis dermatitis
Venous leg ulcers
74
Delayed abnormal reaction to UV light.
Polymorphous light eruption
75
Characterized by the presentation of vesicles, papules, erythematous macules, urticaria plaques. Pink to red in color. Onset after sun exposure.
Polymorphous light eruption
76
Mgmt/treatment for this condition that has an onset after sun exposure?
Condition: polymorphous light eruption Prevention: sun block (though not always helpful) CAM: beta-carotene, niacinamide, vit b6 Prednisone, trimcinolone photochemotherapy (PUVA)
77
Sudden, fixed, symmetrical or generalized skin eruption occurring after starting a new drug or OTC
Drug dermatitis (Drug-related eczema)
78
Mgmt/Treatment for drug dermatitis
Identify and eliminate medication

Derm 1 (8 decks)

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