Eczema & Psoriasis

Question 1

What does eczema mean

Answer 1

• red scaly eruption
• includes: atopic, seborrheic, contact dermatitis, nummular and dishidrotic eczema

Question 2

Signs and symptoms of acute dermatitis

Answer 2

pruritic, erythemic, vesiculated

Question 3

signs and symptoms of chronic dermatitis

Answer 3

pruritic, xerotic, lichenification

Question 4

What is this condition

Answer 4

acute contact dermatitis
-burning, stinging, itching
- sharply demarcated plaques
- superficial edema/vesicles/crusting

Question 5

what is this condition

Answer 5

chronic contact dermatitis
- itchy, dry, peeling
- ill-defined, plaques, lichenification, xerosis
- erythema, fissures, crust, thickening

Question 6

What is the definition of contact dermatitis

Answer 6

acute or chronic inflammatory reaction to something that contacts the skin

Question 7

What are the things that can cause contact dermatitis

Answer 7

irritants and allergens

Question 8

what is this condition

Answer 8

irritant contact dermatitis

Question 9

what type of dermatitis is diaper rash

Answer 9

irritant contact dermatitis

Question 10

what is the street name for this form of irritant contact dermatitis

Answer 10

lip lickers dermatitis

Question 11

characteristics of allergic contact dermatitis

Answer 11

• delayed crescendo reaction (appx 48hrs later) with intense localized itching/burning
• erythema, edema, papules, vesicles, crusting, scaling

Question 12

what is this condition

Answer 12

allergic contact dermatitis

Question 13

what is this condition

Answer 13

allergic contact dermatitis from poison ivy

Question 14

What should contact dermatitis be washed with?

Answer 14

dawn dish soap

Question 15

What should contact dermatitis be treated with

Answer 15

topical corticosteroids and emolient creams, potentially oatmeal soaps, anti-itch measures

Question 16

Classes of topical corticosteroids

Answer 16

Class I: Super potent
Class II-III: high potency
Class IV-V: medium potency
Class VI-VII: low potency

Question 17

General rules for Class I and Class II-III corticosteroids

Answer 17

• limit use to 2-4 weeks to avoid systemic absorption
• smaller areas only
• no occlusion
• avoid on thin skin: face, groin, intergrigenous areas, etc

Question 18

General rules for Class IV-V corticosteroids

Answer 18

• larger body surface area
• use up to 3 months on non-facial and non-intertriginous areas

Question 19

General rules for class VI-VII corticosteroids

Answer 19

• best for thin skin
• okay for long term use on large surface areas
• okay for children

Question 20

what is this skin condition

Answer 20

striae

Question 21

What are some adverse effects of topical corticosteroids

Answer 21

• atrophy
• telangiectasia
• striae
• hypopigmentation
• exacerbation of infections
• allergic contact dermatitis

Question 22

Systemic affects of topical steroids

Answer 22

• cataracts
• immunosuppression
• hyperglycemia
• decreased bone density

Question 23

How much cream/ointment is 1 FTU

Answer 23

500 mg or 0.5 grams

Question 24

what is this condition

Answer 24

atopic dermatitis

Question 25

Atopic dermatitis characteristics

Answer 25

- can be acute, subacute, chronic, relapsing - IgE hypersensitivity reaction - genetic and environmental - 4 pronged treatment - decreased skin barrier function

Question 26

Characteristics of Atopy/Atopic Triad

Answer 26

- Atopic dermatitis - Asthma - Allergies (allergic rhinitis, ASA, food)

Question 27

What are the common sites of atopic dermatitis

Answer 27

Question 28

what is this condition

Answer 28

chronic atopic dermatitis: chronic hand eczema

Question 29

Common DDx for atopic dermatitis

Answer 29

- seborrheic dermatitis - nummular eczema - contact dermatitis - psoriasis - scabies

Question 30

Skin conditions associated with atopic dermatitis

Answer 30

- vitiligo - alopecia areata - wart susceptibility - exaggerated molluscum

Question 31

What is happening with the condition in this image

Answer 31

exaggeration of HSV by atopic dermatitis

Question 32

What may we see in a CBC with diff in someone with atopic dermatitis

Answer 32

eosinophilia (wheezes, sneezes, and weird diseases)

Question 33

What are the 4 prongs of the plan for atopic dermatitis

Answer 33

- antipruritic - antibacterial - moisturizer - anti-inflammatory

Question 34

The topical calcineurin inhibitor ______ is best for moderate to severe atopic dermatitis

Answer 34

tacrolimus

Question 35

The topical calcineurin inhibitor _____ is best for mild to moderate atopic dermatitis

Answer 35

pimecrolimus

Question 36

Which ammonium lactate topical is good for thinning thick/lichenified areas of skin

Answer 36

AmLactin

Question 37

What condition is this

Answer 37

nummular eczema

Question 38

what condition is this

Answer 38

nummular eczema

Question 39

Characteristics of nummular eczema

Answer 39

- 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

Question 40

what is this condition

Answer 40

dyshidrotic eczema

Question 41

Characteristics of dyshydrotic eczema

Answer 41

- 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)

Question 42

What is this condition

Answer 42

seborrheic dermatitis

Question 43

What is this condition

Answer 43

seborrheic dermatitis

Question 44

Characteristics of seborrheic dermatitis

Answer 44

- gradual onset - thick, greasy, yellow, scaly - crusting at ears - lymphadenopathy? - rinse with clear water, soft brush, self-resolving

Question 45

what is this condition

Answer 45

seborrheic dermatitis

Question 46

What is this condition and what test may be needed as follow up

Answer 46

severe seb derm - test for HIV if status unknown

Question 47

Seborrheic dermatitis Ddx

Answer 47

- psoriasis - impetigo - tinea - intertriginous candidiasis - atopic dermatitis

Question 48

what is this condition

Answer 48

psoriasis

Question 49

what is this condition

Answer 49

psoriasis

Question 50

Characteristics of psoriasis

Answer 50

- 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

Question 51

What is this an example of

Answer 51

Koebner phenomenon in psoriasis

Question 52

What kind of psoriasis is this

Answer 52

chronic plaque psoriasis

Question 53

what kind of psoriasis is this

Answer 53

Guttate psoriasis (acute eruptive)

Question 54

What kind of psoriasis is this

Answer 54

inverse psoriasis

Question 55

What kind of psoriasis is this

Answer 55

pustular psoriasis

Question 56

what kind of psoriasis is this

Answer 56

erythrodermic psoriasis

Question 57

DDx for psoriasis

Answer 57

- discoid/nummular eczema - cutaneous Tcell lymphoma - tinea corporis

Question 58

What condition is this

Answer 58

psoriatic arthritis

Question 59

characteristics of psoriatic arthritis

Answer 59

- rare before age 20 - distal hands/feet, small joints - red, swollen, tender joints

Question 60

Tx of psoriasis

Answer 60

- soak scales off - topical corticosteroid ointment - steroid injection - Vit D analog - tar products - bland emollients - UV light - calcineurin inhibitors - methotrexate - biologics

Question 61

Answer 61

C

Question 62

Answer 62

B

Question 63

What does xerosis mean

Answer 63

dry skin

Question 64

patient presents with itchy, swollen upper eyelids. What product/substance may be involved?

Answer 64

cosmetics with cobalt - atopic dermatitis

Question 65

The medical term for itchy is _____ and itching is _____

Answer 65

pruritic, pruritis

Question 66

Cerave, vanicream, vaseline, aquaphor, and eucerine are examples of what?

Answer 66

emollients

Question 67

What formulation of topical steroids is the most potent

Answer 67

ointment