eczema lgw Flashcards
DDx of nappy rash
contact dermatitis - most common cause
candida dermatitis - second most common cause
features of contact dermatitis vs candida dermatitis ?
contact dermatitis : spares skin folds/creases
candida dermatitis: beefy red rash involving thee skin folds/creases , shows satellite lesions
treatment for contact dermatitis vs candida dermatitis ?
contact dermatitis - topical barrier ointment or paste (zinc oxide or petrolatum )
candida dermatitis - topical anti fungal therapy
ddx of nappy rash ?
- Candidiasis
- Irritant contact dermatitis (flexures typically
spared) - Seborrheic dermatitis
- Bacterial infection (no pustules nor blisters)
* Bullous impetigo
* Streptococcal intertrigo - Psoriasis (no family history)
- Allergic contact dermatitis
- Atopic dermatitis (uncommon, no family history)
how to manage case of candida dermatitis nappy rash
- Stop the use of the highly potent corticosteroid
- In acute phase: mild corticosteroid
- Add topical imidazole cream for candida infection
- Educate the mother on how to change her daughter’s diapers
types of contact dermatitis ?
allergic contact dermatitis - type 4 delayed hypersensitivity
irritant contact dermatitis
contact dermatitis diagnosis
history of allergy
patch test
clinical features
what are the reasons for suspecting contact dermatitis ?
- Acute or chronic eczema not responding or aggravated by treatment
- Chronic hand or foot eczema
- Facial eczema
- Varicose eczema, particularly if not responding or deteriorating
- Chronic anogenital inflammatory disorders
- Eczema that appears to be work-related
what must be suspected in severe treatment resistant seborrheic dermatitis ?
HIV infection
what is the aetiology of seborrheic dermatitis ?
1- active sebaceous gland
2- abnormal sebum composition
3 - commensals malasseza furfur , pityrosporum orbiculare
what diseases are highly associated with seborrheic dermatitis ?
parkinsons
syringomyelia
facial paralysis
underlying HIV infection
infantile vs adult onset seborrheic dermatitis
- infantile
age of onset : first 3 months
presentation: cradle cap, affecting the skin folds, nappy rash
lesions : well demarcated erythematous patches, thin plaques with bran like to greasy scales
course and prognosis:
prognosis: mild and self limiting within the first year - adult onset
age of onset : puberty , peak at 4th to 5th decade
presentation: scales on medial eyebrow, nasolabial fold, retro-auricular
lesions : well demarcated erythematous patches, thin plaques with bran like to greasy scales
course and prognosis:
prognosis: limited in extent chronic relapsing course
Tx for seborrheic dermatitis ?
- Antifungal shampoo
- Corticosteroid scalp application * Topical steroids
- Oral ketoconazole/itraconazole
eexamples of atopic stigmata ?
periorbital darkening
dennie-morgan folds
xerosis
post inflammatory hypo or hyper pigmentation
what is woods light ?
tool used to detect fungal infections of the skin or the scalp
