Eczema & Psoriasis Flashcards
What does eczema mean
- red scaly eruption
- includes: atopic, seborrheic, contact dermatitis, nummular and dishidrotic eczema
Signs and symptoms of acute dermatitis
pruritic, erythemic, vesiculated
signs and symptoms of chronic dermatitis
pruritic, xerotic, lichenification
What is this condition
acute contact dermatitis
-burning, stinging, itching
- sharply demarcated plaques
- superficial edema/vesicles/crusting
what is this condition
chronic contact dermatitis
- itchy, dry, peeling
- ill-defined, plaques, lichenification, xerosis
- erythema, fissures, crust, thickening
What is the definition of contact dermatitis
acute or chronic inflammatory reaction to something that contacts the skin
What are the things that can cause contact dermatitis
irritants and allergens
what is this condition
irritant contact dermatitis
what type of dermatitis is diaper rash
irritant contact dermatitis
what is the street name for this form of irritant contact dermatitis
lip lickers dermatitis
characteristics of allergic contact dermatitis
- delayed crescendo reaction (appx 48hrs later) with intense localized itching/burning
- erythema, edema, papules, vesicles, crusting, scaling
what is this condition
allergic contact dermatitis
what is this condition
allergic contact dermatitis from poison ivy
What should contact dermatitis be washed with?
dawn dish soap
What should contact dermatitis be treated with
topical corticosteroids and emolient creams, potentially oatmeal soaps, anti-itch measures
Classes of topical corticosteroids
Class I: Super potent
Class II-III: high potency
Class IV-V: medium potency
Class VI-VII: low potency
General rules for Class I and Class II-III corticosteroids
- limit use to 2-4 weeks to avoid systemic absorption
- smaller areas only
- no occlusion
- avoid on thin skin: face, groin, intergrigenous areas, etc
General rules for Class IV-V corticosteroids
- larger body surface area
- use up to 3 months on non-facial and non-intertriginous areas
General rules for class VI-VII corticosteroids
- best for thin skin
- okay for long term use on large surface areas
- okay for children
what is this skin condition
striae
What are some adverse effects of topical corticosteroids
- atrophy
- telangiectasia
- striae
- hypopigmentation
- exacerbation of infections
- allergic contact dermatitis
Systemic affects of topical steroids
- cataracts
- immunosuppression
- hyperglycemia
- decreased bone density
How much cream/ointment is 1 FTU
500 mg or 0.5 grams
what is this condition
atopic dermatitis
Atopic dermatitis characteristics
- can be acute, subacute, chronic, relapsing
- IgE hypersensitivity reaction
- genetic and environmental
- 4 pronged treatment
- decreased skin barrier function
Characteristics of Atopy/Atopic Triad
- Atopic dermatitis
- Asthma
- Allergies (allergic rhinitis, ASA, food)
What are the common sites of atopic dermatitis
what is this condition
chronic atopic dermatitis: chronic hand eczema
Common DDx for atopic dermatitis
- seborrheic dermatitis
- nummular eczema
- contact dermatitis
- psoriasis
- scabies
Skin conditions associated with atopic dermatitis
- vitiligo
- alopecia areata
- wart susceptibility
- exaggerated molluscum
What is happening with the condition in this image
exaggeration of HSV by atopic dermatitis
What may we see in a CBC with diff in someone with atopic dermatitis
eosinophilia (wheezes, sneezes, and weird diseases)
What are the 4 prongs of the plan for atopic dermatitis
- antipruritic
- antibacterial
- moisturizer
- anti-inflammatory
The topical calcineurin inhibitor ______ is best for moderate to severe atopic dermatitis
tacrolimus
The topical calcineurin inhibitor _____ is best for mild to moderate atopic dermatitis
pimecrolimus
Which ammonium lactate topical is good for thinning thick/lichenified areas of skin
AmLactin
What condition is this
nummular eczema
what condition is this
nummular eczema
Characteristics of nummular eczema
- pruritic
- coin-shaped plaques of small papules/vesicles on erythematous base with no central clearing
- greater in males than females
- common in fall/winter
- Ddx: Tinea corporis
- Tx: topical steroids, emollients
what is this condition
dyshidrotic eczema
Characteristics of dyshydrotic eczema
- vesicular hand and foot dermatitis
- acute, chronic, recurrent
- sudden, deep, pruritic vesicles (painful)
- Ddx: scabies, tinea pedis, contact dermatitis
- Tx: clobetasol, topical steroids with occlusion, steroid injection)
What is this condition
seborrheic dermatitis
What is this condition
seborrheic dermatitis
Characteristics of seborrheic dermatitis
- gradual onset
- thick, greasy, yellow, scaly
- crusting at ears
- lymphadenopathy?
- rinse with clear water, soft brush, self-resolving
what is this condition
seborrheic dermatitis
What is this condition and what test may be needed as follow up
severe seb derm - test for HIV if status unknown
Seborrheic dermatitis Ddx
- psoriasis
- impetigo
- tinea
- intertriginous candidiasis
- atopic dermatitis
what is this condition
psoriasis
what is this condition
psoriasis
Characteristics of psoriasis
- bimodal age distribution of onset
- hereditary + environment
- proliferation and poor differentiation of epidermis
- Tcell driven autoreactive immune response
- sharply demarcated silvery white scaling
- positive auspitz sign
What is this an example of
Koebner phenomenon in psoriasis
What kind of psoriasis is this
chronic plaque psoriasis
what kind of psoriasis is this
Guttate psoriasis (acute eruptive)
What kind of psoriasis is this
inverse psoriasis
What kind of psoriasis is this
pustular psoriasis
what kind of psoriasis is this
erythrodermic psoriasis
DDx for psoriasis
- discoid/nummular eczema
- cutaneous Tcell lymphoma
- tinea corporis
What condition is this
psoriatic arthritis
characteristics of psoriatic arthritis
- rare before age 20
- distal hands/feet, small joints
- red, swollen, tender joints
Tx of psoriasis
- soak scales off
- topical corticosteroid ointment
- steroid injection
- Vit D analog
- tar products
- bland emollients
- UV light
- calcineurin inhibitors
- methotrexate
- biologics
C
B
What does xerosis mean
dry skin
patient presents with itchy, swollen upper eyelids. What product/substance may be involved?
cosmetics with cobalt - atopic dermatitis
The medical term for itchy is _____ and itching is _____
pruritic, pruritis
Cerave, vanicream, vaseline, aquaphor, and eucerine are examples of what?
emollients
What formulation of topical steroids is the most potent
ointment
