Eczema - Other

Question 1

Eczema is an inflammatory skin condition that causes dry skin, itchy skin, rashes, scaly patches, blisters and skin infections. Which of the following is the 2nd most common form of eczema?

1 - atopic dermatitis
2 - idiopathic eczema/dermatitis
3 - microbial eczema/dermatitis
4 - seborrheic eczema/dermatitis

Answer 1

4 - seborrheic eczema/dermatitis
- a form of chronic but mild eczema, not as severe as atopic dermatitis

• there are infantile and adult forms

Question 2

Seborrheic eczema/dermatitis is the 2nd most common form of eczema. Typically, what is the primary cause of this?

1 - autoimmune reaction
2 - sebum overproduction and commensal yeast Malassezia
3 - mutations in filaggrin gene epidermal barrier function
4 - transepidermal water loss

Answer 2

2 - sebum overproduction and commensal yeast Malassezia

• common in high sebum producing areas such as large body folds.

Question 3

Seborrheic eczema/dermatitis is the 2nd most common form of eczema. Is this more common in men or women?

Answer 3

• men

Question 4

Seborrheic eczema/dermatitis is the 2nd most common form of eczema. This is associated with other conditions, including all of the following EXCEPT which one?

1 - hepatitis
2 - HIV
3 - Parkinson’s
4 - mood disorders

Answer 4

1 - hepatitis

Question 5

Which of the following is a clinical presentation of Seborrheic eczema/dermatitis?

1 - xerosis
2 - Icthyosis vulgaris
3 - Keratosis pilaris
4 - bran-like to flaky greasy scales

Answer 5

4 - bran-like to flaky greasy scales
- all others are associated with atopic dermatitis

Major difference:
- Seborrheic eczema/dermatitis =oliy/greasy
- atopic dermatitis = dry

Question 6

Which of the following locations is Seborrheic eczema/dermatitis least likely to be commonly found?

1 - scalp and face
2 - ears
3 - pre-sternal areas
4 - palmer surfaces

Answer 6

4 - palmer surfaces
- typically low levels of sebum here so unlikely to present

• mild to moderate discomfort and rarely extensive

Question 7

When does infantile seborrheic eczema/dermatitis typically begin?

1 - <12 months
2 - <3 months
3 - <1 month
4 - <1 week

Answer 7

4 - <1 week
- can persist for months

Question 8

What is the term commonly used for seborrheic eczema/dermatitis in infants?

1 - tinea capitis
2 - atopic march
3 - cradle cap
4 - impetigo cap

Answer 8

3 - cradle cap
- typically because it affects the head
- other lesions are uncommon but can occur

Question 9

Cradle cap is used to describe infantile seborrheic eczema/dermatitis. What can the lesions become superinfected with?

1 - staphylococcus aureus
2 - streptococcus
3 - candida
4 - aspergillus

Answer 9

3 - candida

Question 10

Which of the following is NOT true about seborrheic eczema/dermatitis when compared with atopic dermatitis?

1 - earlier age of onset
2 - distribution
3 - more inflammation
4 - absence of pruritus (ithcyness), irritability and sleeplessness
5 - irritant diaper dermatitis – spares skin folds
6 - more greasy/oily lesions

Answer 10

3 - more inflammation
- typically less inflammation than atopic dermatitis

Question 11

In the adult form of Seborrheic eczema/dermatitis, which body part is most commonly affected?

1 - scalp and face
2 - scalp
3 - pre-sternal areas
4 - palmer surfaces

Answer 11

2 - scalp
- can cause dandruff

Question 12

In adult Seborrheic eczema/dermatitis, the scalp is the main body part affected. Which other body part are most commonly affected?

1 - forehead
2 - medial eyebrows
3 - upper eyelids
4 - nasolabial folds
5 - retroauricular regions
6 - all of the above

Answer 12

6 - all of the above
-typically parts of the head are the areas that are affected

Question 13

Which of the following does adult seborrheic eczema/dermatitis typically not lead to?

1 - erythroderma
2 - alopecia
3 - folliculitis
4 - meibomitis
5 - intertrigo

Answer 13

1 - erythroderma
- this is a dangerous complication in atopic dermatitis

intertrigo = inflammation of skin due to skin rubbing together

meibomitis = inflammation of the meibomian glands (glands that secrete oil at bottom of eyes) closely related to blepharitis.

Question 14

Which 2 of the following can typically be used to treat infantile seborrheic eczema/dermatitis?

1 - bathing and emollient application
2 - topical azoles – ketoconazole
3 - low potency topical steroids
4 - topical steroids for acute flares
5 - calcineurin inhibitors

Answer 14

1 - bathing and emollient application
3 - low potency topical steroids

Question 15

Which 2 of the following is typically used to treat more severe forms of infantile seborrheic eczema/dermatitis?

1 - bathing and emollient application
2 - topical azoles – ketoconazole
3 - low potency topical steroids
4 - topical steroids for acute flares (calcineurin inhibitors)

Answer 15

2 - topical azoles – ketoconazole
4 - topical steroids for acute flares (calcineurin inhibitors)

Question 16

Asteatotic eczema, is a form of eczema that can cause dry, dull, flaky skin with a cracked appearance. What season is this most commonly observed in?

1 - Spring
2 - Summer
3 - Autumn
4 - Winter

Answer 16

4 - Winter
- common in dry and cold climates

Question 17

Asteatotic eczema, is a form of eczema that can cause dry, dull, flaky skin with a cracked appearance. Which 2 regions of the body is this common in?

1 - shins
2 - thighs
3 - flanks
4 - head

Answer 17

1 - shins
3 - flanks

Question 18

Asteatotic eczema, is a form of eczema that can cause dry, dull, flaky skin with a cracked appearance. Which age group does this typically affect?

1 - infants
2 - children
3 - adults
4 - elderly

Answer 18

4 - elderly
- ageing is a contributing factor

Question 19

Asteatotic eczema, is a form of eczema that can cause dry, dull, flaky skin with a cracked appearance. Which of the following is NOT a contributing factor to asteatotic eczema?

1 - aging,
2 - gender
3 - xerosis (dry skin)
4 - low humidity
5 - regular bathing

Answer 19

2 - gender

Question 20

Asteatotic eczema, is a form of eczema that can cause dry, dull, flaky skin with a cracked appearance. Dysfunction in which layer of the skin typically causes this condition?

1 - statum granulosum
2 - stratum lucidum
3 - stratum corneum
4 - stratum basalis

Answer 20

3 - stratum corneum

Question 21

Which 2 of the following are typically used to treat Asteatotic eczema?

1 - phototherapy
2 - regular emollients
3 - topical steroids
4 - bleach bathing

Answer 21

2 - regular emollients
3 - topical steroids
- occasional use

Question 22

Stasis dermatitis is a common type of eczema that develops in people due to what?

1 - ageing
2 - cold temperatures
3 - dysfunctional epidermal surface
4 - venous hypertension

Answer 22

4 - venous hypertension
- essentially poor blood flow

Question 23

Stasis dermatitis is a common type of eczema that develops in people due topoor blood flow. Which body part is most commonly affected?

1 - head
2 - hands
3 - lower legs
4 - abdomen

Answer 23

3 - lower legs

Can cause:
- varicose ulcer may be seen
- pitting pedal oedema
- stasis purpura, redness
- several bouts - induration

Question 24

Stasis dermatitis is a common type of eczema that develops in people due topoor blood flow. This can lead to autosensitisation, what is this?

1 - other parts of skin become overly sensitive and develop lesions
2 - anaphylactic emergency
3 - systemic vascular sensitisation to antigens causing inflammation
4 - all of the above

Answer 24

1 - other parts of skin become overly sensitive and develop lesions

Question 25

Venous stasis is due to poor blood flow in the peripheries. Which of the following does chronic stasis NOT typically cause? 1 - Lipodermatosclerosis 2 - Inverted wine bottle appearance 3 - Atrophie blanche 4 - Erythroderma 5 - Erythema and scaling 6 - Oozing, crusting, Itching 7 - Ulceration

Answer 25

4 - Erythroderma - severe and potentially life-threatening inflammation of most of the body's skin surface

Question 26

Which of the following can be used to treat chronic venous stasis? 1 - Compression bandages /stockings 2 - Calf muscle exercises 3 - General management of eczema 4 - all of the above

Answer 26

4 - all of the above

Question 27

Nummular dermatitis (also called discoid eczema) is another form of eczema. Which of the following does nummular dermatitis present with? 1 - Coin shaped ,disseminated , eczematous lesions 2 - Very pruritic 3 - Chronic course 4 - Common on extremities 5 - Can be lichenified 6 - Superadded bacterial infection 7 - all of the above

Answer 27

7 - all of the above - lichenified = thickened and leathery skin

Question 28

What is disseminated eczema caused by? 1 - broken skin becoming infected 2 - disseminated intravascular coagulation 3 - rhinitis 4 - auto sensitisation

Answer 28

4 - auto sensitisation - 1 part of body has lesion which then causes systemic lesions - commonly seen with allergic contact dermatitis and stasis dermatitis

Question 29

Is disseminated eczema caused by one specific type of eczema?

Answer 29

- no any type of eczema can cause this

Question 30

Contact dermatitis is a common form of eczema and is causes when the skin comes into contact with external agents. It can cause all of the following except which one? 1 - pigmentary changes 2 - erythroderma 3 - acne 4 - urticaria 5 - phototoxic reactions 6 - eczema

Answer 30

2 - erythroderma

Question 31

Which 2 of the following are types of contact dermatitis? 1 - irritant contact dermatitis 2 - genetic mutations contact dermatitis 3 - family contact dermatitis 4 - allergic contact dermatitis type IV hypersensitivity

Answer 31

1 - irritant contact dermatitis 2 - allergic contact dermatitis type IV hypersensitivity

Question 32

There are 2 types of contact dermatitis - irritant contact dermatitis - allergic contact dermatitis type IV hypersensitivity Which of these accounts for 80% of contact dermatitis cases?

Answer 32

- irritant contact dermatitis Common irritants: Alkalis, acids ,metal salts Solvents, alcohols/glycols Detergents and cleansers Disinfectants Plastics –thermoplastics(polyacrylates),thermosettings(epoxy resins),elastomers(synthetic rubbers) Food and food additives Water Bodily fluids

Question 33

There are 2 types of contact dermatitis, irritant and allergic contact dermatitis. What type of hypersensitivity is this? 1 - I = reaction mediated by IgE antibodies. 2 - II =c ytotoxic reaction mediated by IgG or IgM antibodies. 3 - III = reaction mediated by immune complexes. 4 - IV = delayed reaction mediated by cellular response

Answer 33

4 - IV = delayed reaction mediated by cellular response - patients are typically already sensitised

Question 34

In allergic contact dermatitis, is the reaction systemic or well demarcated at the site of contact?

Answer 34

- well demarcated

Question 35

What is the gold standard for diagnosing allergic contact dermatitis? 1 - skin biopsy 2 - skin irritant diary 3 - patch testing 4 - all of above together

Answer 35

3 - patch testing - Nickel and poison Ivy –most common

Question 36

Patch testing is the gold standard to diagnose allergic contact dermatitis with patches applied to the upper back. How long do patients wear these for? 1 - 1 day 2 - 2 days 3 - 4 days 4 - 6 days

Answer 36

2 - 2 days - the read at 4 days - maybe some delayed reaction on day 7 - if see things on day 2 maybe an irritant reaction, but day 4 = allergic reaction

Question 37

How is contact dermatitis treated? 1 - Patient education 2 - Information leaflets 3 - Reading small print 4 - Textile dye dermatitis 5 - Systemic contact dermatitis 6 - Airborne contact dermatitis 7 - CD to prescription medications 8 - all of the above

Answer 37

8 - all of the above - essentially avoid where possible