eczematous d/o

Question 1

what does dermatitis mean

Answer 1

inflamed skin

Question 2

cause of atopic dermatitis/eczema

Answer 2

imbalance of immune system w/ TH2 predominance

Question 3

which dermatitis is associated w/ other forms of atopy like asthma and allergic rhinitis

Answer 3

atopic dermatitis (eczema)

Question 4

what bacteria aggrevates eczema

Answer 4

s. aureus

Question 5

filaggrin defect/barrier dysfunction and repeated allergen exposure

Answer 5

eczema pathogenesis

Question 6

describe eczema

Answer 6

scaly, ill-defined red patches; may be lichenified

Question 7

infant vs adult location for eczema

Answer 7

infant: extensor arms, legs, butt
adult: neck, flexor areas
both: face

Question 8

on darker skin its more likely to be present with associated pityriasis alba (post-inflammatory hypopig.)

Answer 8

eczema

Question 9

how is eczema treated

Answer 9

barrier repair & maintenance
dilute bleach baths if crusted
antihistamines for other atopy
topical steroids for breakthrough

Question 10

consequence of having eczema and being exposed to herpes?

Answer 10

eczema herpetiform (severe widespread lesions)

Question 11

delayed TH1/ type IV hypersensitivity where theres an itchy rash affecting area exposed to allergen

Answer 11

allergic contact dermatitis

Question 12

what type of molecules are most allergens?

Answer 12

haptens– they bind to native proteins

Question 13

list 4 common allergens

Answer 13

nickel
fragrances
preservatives
topical abx (neomycin)

Question 14

timeline of rash for contact dermatitis

Answer 14

takes 1-2 wks for sensitization & 24-48 hrs to 4-7 days on re-exposure

Question 15

2-7 days after re-exposure they have itch red papules & vesicles. what is this the clinical features of?

Answer 15

contact dermatitis

Question 16

describe nummular dermatitis and where it is & what it is likely related to

Answer 16

sharply defined, discoid or circular coin shaped & itchy
on lower legs and trunk
likely related to dry skin

Question 17

tx of nummular dermatitis (2)

Answer 17

skin hydration and protection
may need high-potency topical steroids

Question 18

which dermatitis is not eczematous but is actually a variant of rosacea?

Answer 18

perioral dermatitis

Question 19

this dermatitis features small papules around the mouth or eyes and is related to chronic steroid use

Answer 19

perioral dermatitis

Question 20

how is perioral dermatitis tx (1)

Answer 20

topical erythromycin for anti-inflammatory effect

Question 21

which dermatitis is a hypersensitivity to malassezia yeast

Answer 21

seborrheic (dandruff)

Question 22

describe seborrheic dermatitis & if it itches

Answer 22

yellowish greasy scale
rarely itches

Question 23

list locations of seborrheic dermatitis (7)

Answer 23

scalp, brows, nasolabial folds, ears, chest inguinal creases, axilla

Question 24

difference between dandruff and psoriasis

Answer 24

dandruff: ill defined waxy greasy scale
psoriasis: well defined, micaceous flaky scale; also on elbows knees, umbilicus, nails (unlike dandruff)

Question 25

how is dandruff treated? (2)

Answer 25

OTC or Rx anti-dandruff shampoo
topical steroid if resistant to tx (low potency on face & intermediate on scalp)

Question 26

chronic edema of legs leading to skin inflammation

Answer 26

stasis

Question 27

describe stasis (2)

Answer 27

bawny redness of both calves with piting edema & itching, very sensitive to allergens

Question 28

should you use neosporin/bacitracin with dermatitis

Answer 28

should avoid it especially with stasis

Question 29

how is stasis treated? (3)

Answer 29

compression socks, leg elevation for long-term
wt loss for long term
mid potency steroid (triamcinolone) for itching

Question 30

which dermatitis is a variant of irritant &/or atopic dermatitis with small minimally-inflamed itchy vesicles on palms, lateral fingers and feet?

Answer 30

dyshidrosis

Question 31

what seems to make dyshidrosis flare? (3 S’s)

Answer 31

stress
sweating
seasonal changes

Question 32

how is dyshidrosis treated (2)

Answer 32

strong steroids
skin barrier protection

Question 33

what condition is a result of chronic rubbing/scratching causing the skin to thicken for protection

Answer 33

lichen simplex chronicus

Question 34

describe lichen simplex chronicus

Answer 34

alligator skin
prurigo nodule– localized area of LSC

Question 35

how is LSC managed

Answer 35

high potency corticosteroid
patient counseling regarding itching

Question 36

patient education for atopic dermatitis (2)

Answer 36

bath infrequently with lukewarm water and moisturize after
if its crusted, using 1/2 cup bleach in full tub of water can reduce s. aureus

Question 37

how is chemical diaper dermatitis different from candidal diaper dermatitis

Answer 37

chemical spares the creases while candidal doesn’t
candidal has peripheral satellite pustules

Question 38

how do you tx chemical vs candidal diaper dermatitis?

Answer 38

both: moisure control and zinc oxide as barrier
candida: can add anti-yeast (nyastin or -azole)
chemical: low-potency steroid only if no yeast

Question 39

only condition in this lecture that RARELY itches

Answer 39

seborrheic dermatitis

Question 40

location of psoriasis vs eczema

Answer 40

psoriasis is on extensors and scalp
eczema is on flexors, face and neck