eczema r Flashcards
what is eczema
chronic atopic condition
pathophysiology of eczema
barrier defect allows irritants and allergens to enter the skin
skin becomes inflamed
risk factors for eczema
FH
filaggrin protein mutations
autoimmune disease e.g. asthma
presentation of eczema
red dry itchy skin
flare ups
Hyperlinearity in filaggrin deficiency
where does the rash usually appear in eczema
flexor surfaces
face
neck
common triggers for eczema
illness stress teething cold air central heating
characteristics of atopic eczema
wide spread diffuse scaly red eruption
very itchy
early onset
when should you be more concerned about atopic eczema
when it presents earlier than 3months old
discoid eczema characteristics
scattered circular patches that recur in the same place
very stubborn to treat
specific treatment for discoid eczema
topical steroid for 14 days then twice a week to maintain
characteristics of seborrheic dermatitis
mainly on scalp and face
proliferation of commensals
very scaly
how would you use topical steroids in eczema
once a day for 1-2 weeks
reduce use if it improves
use once a week on stubborn areas
return to daily use in flare up
what other basic treatments can be used in eczema
emollients
soap substitutes
fitted physical barriers to present scratching
what should you consider if topical steroids don’t work
consider allergy phototherapy protopic ointment immunosuppressants biologics oral corticosteroids
what immunosuppressants are used
methotrexate
ciclosporin
azathioprine
what biologic can be used in eczema
dupilomab
order of topical steroid ladder from least to most potent
HEBD hydrocortisone eumovate betnovate dermovate
how should steroids be used on the face
try and limit it as much as possible - especially around eyes
use for 3-5 days then stop
repeat when needed
what should you introduce if the patient needs to use steroids on their face regularly
topical tacroliums for 14 days then twice a week
what is eczema herpecticum
viral skin infection caused by HSV or VZV
presentation of eczema herpeticum
widespread painful vesicular rash monomorphic punched out lesions systemic symptoms - fever, lethargy, irritability, reduced oral intake lymphadenopathy history of eczema
investigation in eczema herpeticum
viral swab of rash
management of eczema herpeticum
aciclovir - IV in severe cases
withhold topical steroids for 24hrs
analgesics
opthamology review if near eyes
