Eczematous and papulosquamous disorders

Question 1

Atopic dermatitis Clinical Manifestations

Answer 1

Hallmark of the disease is pruritus
Scratching leads to eczematous change and lichenification
Lesions may ooze, crust and become purulent

Question 2

Nummular eczema

Answer 2

Eczema (atopic dermatitis) that is described as coin shaped lesions
Usually occurs on the trunk and lower extremities

Question 3

Contact dermatitis Presentation

Answer 3

Intense pruritus
Rash
Papular, erythematous lesions
Papules from fluid in the epidermis and in severe cases produces vesicles and serous oozing
Exposure may have been as far back as 2 weeks ago

Question 4

Diaper Dermatitis Treatment

Answer 4

Without secondary yeast infection:
Frequent diaper changes
Barrier treatment with Vaseline or Desitin
With secondary yeast infection:
Topical antifungal such as nystatin, miconazole or clotrimazole
Barrier lubricants such as Vaseline
No steroids

Question 5

Perioral Dermatitis Features

Answer 5

Sparing of skin adjacent to vermillion border

Co-existing feature of eczematous dermatitis

Question 6

Seborrheic dermatitis

Answer 6

May be widespread in HIV and Parkinson’s disease

Erythematous scaling patches develop in areas of sebaceous glands (scalp, face, trunk)

Question 7

Stasis dermatitis

Answer 7

Occurs from blood pooling due to chronic venous insufficiency
Increased pressure in the capillaries with subsequent extravasation
Hemosiderin from the blood cells stain the skin
Treatment is aimed at prevention of edema and blood pooling with compression stockings and elevation of the legs

Question 8

Lichen planus

Answer 8

May be medication induced
Shiny, flat, polygonal, violaceous papules or plaques with white lacy pattern called Wickham’s striae
White reticulate lesions occur on mucosal surfaces
Intensely pruritic