Eczematous Eruptions

Question 1

Define Atopic Dermatitits

Answer 1

Chronic pruritic inflammatory eczematous eruption

Question 2

Identify signs and symptoms of Atopic Dermatitis

Answer 2

• Pruritis, burning, erythema, scaling, crusting, lichenification
• Commonly affected areas are face, neck, antecubital and popliteal spaces (flexor surfaces)
• Worse in winter

Question 3

List treatments available for Atopic Dermatitis

Answer 3

No Cure!! Treatment includes medical management of symptoms and lifestyle changes
- Good skincare
- Topical steroids
- Oral steroids for acute episodes only
- Antihistamines
- Abx for infection
- Dupixent (SQ injectable biologic for moderate to severe uncontrolled)
- JAK inhibitors

Question 4

Differentiate between irritant and allergic contact dermatitis

Answer 4

Irritant Contact Dermatitis is when a substance produces a direct toxic effect to the skin only where the substance contacts the skin.

Allergic Contact Dermatitis is when an immunologic reaction triggers inflammation (I.e. poison ivy spreading)

Question 5

List treatments for contact dermatitis

Answer 5

• Remove the offender
• Topical and Oral steroids
• Antihistamines
• Prevention and avoidance

Question 6

Identify signs and symptoms of seborrheic dermatitis

Answer 6

• Occurs in hairy areas of the body (scalp, face, chest)
• White or yellow scale, flaky, background erythema, greasy appearance
• May or may not be pruritic
• High rates of occurrence in HIV/AIDS and Parkinson Disease

Question 7

List treatments available for seborrheic dermatitis

Answer 7

• Shampoos
• Topical steroids
• Topical antifungals

Question 8

Identify cause and features of lichen simplex chronicus

Answer 8

• Chronic itch stretch cycle (self perpetuated behavior)
• Skin becomes lichenified, usually in areas where the patient can reach
• May be secondary to another diagnosis

Question 9

List treatments for lichen simplex chronicus

Answer 9

• Potent topical steroid use (class 1 or 2)
• IL steroids
• Anti pruritic
• Behavior modification

Question 10

Identify features of statis dermatitis

Answer 10

• Occurs on lower legs secondary to vascular disease
• Skin will be erythematous or with brown pigment
• Texture may be shiny, edematous, may ulcerate

Question 11

Identify causes of statis dermatitis

Answer 11

• Vascular insufficiency starves the skin of blood supply

Question 12

Identify treatment of statis dermatitis

Answer 12

• Topical steroids
• Elevation
• Compression stockings

Question 13

Identify features of dyshidrotic eczema

Answer 13

• Vesicular eczematous eruption usually occurs at hands or feet
• Small vesicles (tapioca), very pruritic, diffuse peeling after a flare
• Recurrent

Question 14

Identify causes of dyshidrotic eczema

Answer 14

• Occurs in areas of high moisture/water exposure

Question 15

Identify treatment for dyshidrotic eczema

Answer 15

• Prevention (decrease hand washing, gloves, cotton socks changed frequently, avoid irritants)
• Topical and/or systemic steroids
• Phototherapy