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Dermatology > Eczema & Dermatitis - KK > Flashcards

Eczema & Dermatitis - KK Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the characteristics of Acute Eczematous Inflammation?

A
  • Acute
  • Erythema, papules, vesicles
  • oozing +/- crusting
  • Distinct margins
  • intense pruritus
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2
Q

What is the Tx for Acute Eczematous Inflammation?

A

topical steroids
antihistamines
oral steroids
antibiotics

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3
Q

What are the characteristics of Subacute Eczematous Inflammation?

A
  • Most frequently encountered
  • Erythema, scale, scalded appearance, fissuring
  • Moderate itch, pain, stinging
  • Indistinct margins
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4
Q

What is the Tx for Subacute Eczematous Inflammation?

A

topical steroids
lubrication
antihistamines
antibiotics

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5
Q

What are the characteristics of chronic eczematous inflammation?

A
  • Thick Skin (lichenification)

- excoriations, fissuring

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6
Q

What is the Tx for chronic eczematous inflammation?

A
  • Topical steroids
  • intralesionals
  • antihistamines
  • antibiotics
  • lubrication
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7
Q

What is the pathogenesis for atopic dermatitis?

A
  • Skin barrier abnormalities
  • defects in innate immunity response
  • th2-skewed adaptive immune response
  • Altered skin resident microbial flora
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8
Q

Is atopic dermatitis more common in adults or children? males or females?

A

More common in children and female to male preponderance of 1.3:1

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9
Q

Atopic Dermatitis is associated with elevated serum levels of…?

A

Immunoglobulin E (family history of atopy)

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10
Q

What are the clinical features of Atopic Dermatitis?

A
  • Dry skin and severe pruritus

- Can be acute or subacute/chronic

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11
Q

What are the primary treatment recommendations for Atopic Dermatitis?

A
  • Avoid triggers (heat)
  • Treat stress and anxiety
  • Minimize use of soap (superfatted soaps best)
  • Frequent systemic lubrication with oil baths, moisturizers, etc.
  • Humidify the house (40% to 60% in all rooms, all-year round)
  • After bathing pat dry (avoid rubbing, which removes natural skin oils) and put on ointment, oils, or emolient moisturizer
  • Use oil/moisturizer within 3 minutes after soaking/bathing
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12
Q

What medications can be used to treat Atopic Dermatitis?

A
  • Topical Corticosteroids → First line (triamcinolone 0.1%, betamethasone diproprionate 0.05% q day-BID x 2 weeks)
  • May need to consider systemic corticosteroids
  • Topical calcineurin inhibitors (if on face, neck)
  • Treat skin infections
  • Use antihistamines and control itching
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13
Q

What is the cause of a Secondary Infection of Atopic Dermatitis, and what medication would you use to treat?

A

-Due to skin barrier being broken, secondary infection common (S. aureus)
-Medications
→ MSSA: Amoxicillin/clavulanic acid
→ MRSA: Mupirocin 2%, Bactrim

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14
Q

What are the two categories of contact dermatitis?

A

Allergic & Irritant Contact Dermatitis

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15
Q

What type of hypersensitivity reaction does Allergic Contact Dermatitis elicit?

A

Delayed (type IV) hypersensitivity

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16
Q

What is the most common sensitizer in North America?

A

Oleoresin urushiol (poison ivy, oak, sumac)

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17
Q

What is the GOLD standard for Dx of allergic contact dermatitis?

A

Patch Testing

18
Q

What are the characteristics of Rhus Dermatitis Rash?

A

Intense pruritus and erythema then develop papules or plaques, vesicles, and/or bullae

19
Q

What is the most common metal contact allergen?

A

Nickel (women > men)

20
Q

What is the primary treatment for Contact Dermatitis?

A

1) emollients, soap substitutes → repair the skin barrier
2) Prevention!
3) Topicals containing menthol & phenol
4) High potency topical corticosteroids
5) Oral antihistamines
6) systemic corticosteroids

21
Q

What distinguishes a mild diaper dermatitis from a moderate/severe diaper dermatitis?

A

Mild → mild maceration and frictional irritation
Moderate → maceration or superficial erosions
Severe → extensive, glossy, painful erosions, papules, nodules

22
Q

What is the Tx for Diaper dermatitis?

A
  • dry diapers after proper cleaning with mild soap/H20
  • Zinc oxide
  • Steroids if severe
23
Q

What is the difference between Contact/Irritant diaper dermatitis and Candida diaper dermatitis?

A

Contact: no satellite lesions & avoids creases
Candida: satellite lesions & in creases predominantly

24
Q

What is dyshidrotic eczema and where is it found normally?

A
  • intensely pruritic chronic and recurrent vesicular dermatitis of unknown etiology
  • Involves the palms and soles and lateral aspects of the fingers
25
Q

What are the metals associated as possible triggers for dyshidrotic eczema?

A

Nickel, Cobalt, Chromium

26
Q

What is the Tx of dyshidrotic eczema?

A

1) Aluminum subacetate (Burow’s solution) or witch hazel for weeping
2) Systemic corticosteroids if severe
3) PUVA therapy for non-responsive cases

27
Q

What are the characteristics of nummular eczema?

A
  • chronic

- multiple pruritic, coin-shaped eczematous lesions involving the extremities

28
Q

What is the Tx for severe unresponsive nummular eczema?

A

Narrowband ultraviolet B (NBUVB) therapy x 10-30 treatments

29
Q

Seborrheic Dermatitis is found in areas with a high density of…?

A

sebaceous glands

30
Q

Seborrheic Dermatitis is found in areas with a high density of…?

A

sebaceous glands

31
Q

What is stasis dermatitis and what condition is it associated with?

A

-Inflammatory dermatosis of the lower extremities occuring in patient with chronic venous insufficiency

32
Q

What is lipidodermatosclerosis?

A

chronic form of panniculitis resulting from chronic inflammation, fat degeneration, and fibrosis (usually associated with the ankle region)

33
Q

What is the Tx for stasis dermatitis?

A
  • Tx of the underlying chronic venous insufficiency

- Symptomatic Tx of skin dryness, pruritus, and inflammation

34
Q

Where is asteatotic eczema commonly seen and when does it have its highest incidence?

A
  • occurs on the lower extremities of older individuals with dry skin
  • incidence most in cold winter months (↓ environmental humidity)
35
Q

What is the treatment for Asteatotic eczema?

A

topical corticosteroids

wet dressing with Burows solution

36
Q

What is perioral dermatitis?

A
  • small inflammatory papules around the mouth, nose, or eyes

- primarily women between ages 16-45

37
Q

What is the treatment of perioral dermatitis?

A
  • elimination of corticosteroids and skin irritants
  • calcineurin inhibitors
  • metronidazole
38
Q

What causes Lichen Simplex Chronicus and what is its appearance?

A

1) Secondary skin disorder that results from excessive scratching
→ Created and perpetuated by constant scratching and rubbing in patient with no underlying dermatologic condition
2) Appearance
-Lichenified plaques and excoriations
-Very thick oval plaques
-Leathery skin

39
Q

What is the treatment of lichen simplex chronicus?

A
  • Discontinuation of the itch-scratch cycle

- Topical corticosteroids

40
Q

What is the cause of lichen planus?

A

an immune-mediated mechanism involving activated T-cells (Hep C)

41
Q

What are the 6 “P”s of Lichen Planus?

A
  • Pruritic
  • Purple
  • Polygonal
  • Papules
  • Plaques
  • Planar
42
Q

What is the treatment of lichen planus?

A
  • high potency or super high potency topical corticosteroid (Betamethasone dipropionate 0.05%)
  • Intralesional corticosteroids

Dermatology (14 decks)

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