Eczema - Others Flashcards

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1
Q

Other than Atopic Eczema, what are the main types?

A

Exogenous Causes:

  • Contact Dermititis
  • Lichen Simplex
  • Photoallergic Eczema

Endogenous Causes:

  • Discoid
  • Venous
  • Seborhoeaic
  • Pompholyx
  • Juvenile Plantar Dematitis
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2
Q

How would you spot photoallergic eczema?

A

It shows a distribution around light exposed areas

I.e. Face, Sleeve lines, neck line etc.

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3
Q

Explain how Contact Dermatitis works

A

Comes in 2 Forms:

  • Allergic (Type 4 hypersensitivity reaction)
  • Irritant (Friction, cold, long water exposure or chemicals e.g. detergent)
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4
Q

What occupations get a lot of contact dermatitis?

A
  • Hairdressers (lots of washing & water)
  • NHS staff (Constantly washing hands)
  • Cleaners (Detergents and acids)
  • Babies (not an occupation, but get a lot of contact nappy rash)
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5
Q

Explain what discoid eczema is?

A

Circular plaques of eczema. Mainly at sites of irritation

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6
Q

If you find eczema on an infants scalp, proximal flexures and trunk what do you think it is?

A

Seborrhoeic Eczema

Because it targets areas where there’s lots of sebaescous glands like the scalp, armpits and chest

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7
Q

So what causes Seborrhoeic Eczema and how do you treat it?

A

Usually a Malassezia Yeast infection

Topical Ketoconazole

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8
Q

You might get more patients during the winter months coming in with very dry skin thats cracked an scaly, mostly on thier shins. Why is that?

A

They have asteatotic eczema.

It occurs when the skin becomes very dry such as:

  • In hot climates
  • Excessive soap washing
  • Cold months (people spend a lot of time indoors with dry heating)
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9
Q

A patient presents with intensely itchy sudden crops of vesicles appearing on their hands and feet along with redness and flaking?

A
Probably Pompholyx (aka vesicular dermatitis)
A form of eczema involving formation of blisters on the hands/feet
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10
Q

Explain how venous eczema occurs?

A

Increased venous pressure (mostly legs)
Causes oedema
Body reacts to oedema triggering eczema

So it presents with the classic red, flaky, itchy eczema. Possibly plus:

  • Varicose Veins
  • Brown/red discolouration
  • Swelling
  • Pain
  • Hardened/tight skin (lipodermatosclerosis)
  • White “scars” (atrophie blanche)
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11
Q

Finally what happens if a patient with eczema gets a disseminated HSV infection?

A

Eczema Herpeticum!

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12
Q

How does Eczema Herpeticum present?

A

Painful eczema getting rapidly worse
Clusters of blisters and ‘punched-out’ erosions
Fever, lethargy and malaise

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13
Q

How would we treat venous eczema?

A

Other than standard eczema treatments:

compression stocking - Reduce the oedema, reduce the reaction

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14
Q

How would we treat Eczema Herpeticum?

A

Antiviral Aciclovir to clear the HSV
Mild topical steroid (e.g. hydrocortisone) to lessen the eczema

Get an ophthalmology consult if there’s periocular disease

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15
Q

Explain the presentation of allergic eczema

A

o Allergen taken to Lymph node
o T-cell mediated immune response
o When T cell next encounters allergen= mast cell degranulation, vasodilation, neutrophils
o Patch test: applied on the Monday, removed on the weds, re-assessed on the Friday

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