Eczema/Dermititus

Question 1

what is hyperkeratosis

Answer 1

increased THICKNESS of KERATIN LAYER

Question 2

what is parakeratosis

Answer 2

persistence of NUCLEI in keratin layer

Question 3

what is ancathosis

Answer 3

Increased THICKNESS of EPIDERMIS

Question 4

what histological signs are seen in an eczema skin biopsy

Answer 4

Oedema between the keratinocytes (spongiosis)

inflammatory cell infiltrate

Question 5

what is spongiosis

Answer 5

oedema between keratinocytes

Question 6

what inflammatory cell infiltrate is seen in eczema

Answer 6

acute or chronic with lymphocytes and/pr neutrophils

Question 7

Acute phase of eczema

Answer 7

papulovescular erythematous lesions 
oedema 
ooze 
scaling 
crusting

Question 8

chronic phase of eczema

Answer 8

thickening
elevated plaques
increased scaling

Question 9

what type of reaction is contact allergic dermatitis

Answer 9

delayed type 4 hypersensitivity reaction

Question 10

what is the immunopathology of contact allergic dermatitis

Answer 10

langerhand cells in the epidermis pick up antigens

then present the antigens to Th cells in the dermis

Sensitised Th cells travel to the lymph nodes where the antigen presentation is amplified

next time the antigen is there the specified T cells proliferate and infiltrate the epidermis causing contact allergic dermatitis

Question 11

how do you test for contact allergic dermatitis

Answer 11

PATCH TESTING

put allergens in wells on back
leave wells for 48 hours
remove wells and then check for reaction after 96 hours

Question 12

What is irritant contact dermatitis

Answer 12

non-specific physical irritation rather than specific allergen reaction to things like soap, detergent, cleaning products, water etc

Question 13

how does atopic eczema present

Answer 13

pruritus 
ill defined erythema and scaling 
generalised dry skin 
flexural distribution 
associated with other atopic diseases eg. asthma, allergic rhinitis, food allergy

Question 14

what are some chronic changes seen with atopic eczema

Answer 14

lichenification (thickened leathery skin) 
Exorication (repeated picking of skin) 
Secondary infection 
-staph aures 
-herpes simplex

Question 15

what does a herpes simplex eczema infection look like

Answer 15

monomorphic lesions

Question 16

what is the diagnosis criteria for atopic eczema

Answer 16

itching plus three or more

• visible flexural rash
• history of flexural rash
• personal history of atopy
• generally dry skin
• onset before 2 years old

Question 17

treatment for atopic eczema

Answer 17

plenty of emollients 
avoid irritants including soaps and shower gels 
topical steroids 
treat infection 
phototherapy- UVB 
immunosuppressants 
biological agents

Question 18

what are the other less common types of eczema

Answer 18

drug induced 
photosensitive 
lichen simplex 
stasis dermatitis 
pompholyx

Question 19

what is stasis eczema

Answer 19

secondary to:

• hydrostatic pressure
• oedema
• red cell extravasation

Question 20

what is pompholyx eczema

Answer 20

spongiotic vesicles (intercellular oedema)

Question 21

what is lichen simplex

Answer 21

localised, well circumscribed area of hyper pigmented thickened skin