Eczema/Itchy Skin Flashcards

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1
Q

What are the three main types of eczema?

A

Atopic dermatitis, contact dermatitis (irritant, allergic), drug induced dermatitis

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2
Q

What is the presentation of eczema?

A

Symmetric, ill-defined, erythematous, patches or plaques, lichenification, erosions (from scratching)

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3
Q

What is the typical color of eczema?

A

Light pink, flaming red, may appear purple/brown in darker skin tones

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4
Q

What is lichenification?

A

Thickening of skin, accentuation of skin lines

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5
Q

What is the distribution of atopic dermatitis in infancy?

A

Facial (especially around the mouth) and scalp dermatitis

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6
Q

What is the distribution of atopic dermatitis in early childhood?

A

Extensor surfaces

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7
Q

What is the distribution of atopic dermatitis in older children/young adults?

A

Flexural surfaces

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8
Q

What is the distribution of atopic dermatitis in adults?

A

Head, neck, and hand lesions

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9
Q

What causes lichenification in atopic dermatitis?

A

Scratching/rubbing of chronic lesions causes the accentuation of skin lines

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10
Q

What are the histological features of atopic dermatitis?

A

spongiosis (fluid between cells)

perivascular infiltrate (eosinophils, lymphocytes)

parakeratosis (scale)

acanthosis (thickening of the epidermis)

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11
Q

What is the diagnosis process for atopic dermatitis?

A

Diagnostic criteria, biopsy

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12
Q

What gene mutation is associated with skin barrier dysfunction in atopic dermatitis?

A

A mutation in filaggrin 1, which normally is a major component of skin moisture and barrier functions

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13
Q

What is the mechanism of inflammation in atopic dermatitis?

A

Th2 cells produce IL-13 and IL-4, which leads to downregulation of filaggrin and barrier disruption

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14
Q

What are the psychosocial effects of atopic dermatitis?

A

Sleep disturbances, associations with other comorbidities, self-consciousness, mental health issues, social isolation

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15
Q

What is the influence of climate on atopic dermatitis?

A

Increased eczema prevalence in winter with colder temperatures, low humidity, drier air, less UV exposure

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16
Q

What is the treatment for atopic dermatitis?

A

Topical agents (corticosteroids, calcineurin inhibitors), systemic agents, light therapy and lasers

17
Q

What is the mechanism of dupilumab?

A

It is an IL-4 receptor antagonist (that also blocks IL-13) and treats atopic dermatitis

18
Q

What is the main difference between irritant and allergic contact dermatitis?

A

Irritant does not require previous sensitization, allergic does require previous sensitization

19
Q

What is the mechanism of irritant contact dermatitis?

A

It is mediated by tumor necrosis alpha and non-specific release of junk from damaged cells

20
Q

What is the mechanism of allergic contact dermatitis?

A

Allergens cross skin barrier, binds to langerhans cells, recruitment and expansion of T cell clones that are specific. May also involve IL-9 and IL-17.

21
Q

What class of drugs is the most implicated in drug-induced eczema?

A

Calcium channel blockers

22
Q
A