eczmetaous dermatitis

Question 1

what is dermatitis

Answer 1

inflammation of the skin

Question 2

Eczematous dermatitis may be:

1. Acute
2. Subacute
3. Chronic

Answer 2

1. Acute
   erythema, vesicles
2. Subacute
   erythema, papules/plaques (+/- scale)
3. Chronic
   scale, lichenification (+/- erythema)

Question 3

All eczematous dermatitides are characterized by ________ or epidermal intercellular edema

Answer 3

“spongiosis”

Question 4

One cannot distinguish between different types of eczematous dermatitis on biopsy

Answer 4

yep so true

Question 5

Irregular epidermal
hyperplasia is more 
pronounced
 Spongiosis 
is subtle

Answer 5

chronic spongiotic dermatitis

Question 6

• Childhood eczema that affects 10-20% of children in the US
• Starts after 2 months of age
• 90% of patients will develop it by age 5
• 40% of children will have some form of chronic disease in adulthood
• Occurs in 1/3 of children with personal or family h/o allergic rhinitis

Answer 6

atopic dermatitis

Question 7

stage of atopic dermatitis:

• Acute dermatitis
• Erythematous, edematous, crusted, oozing vesicles, papules
• Located primarily on the face and scalp

Answer 7

infantile

Question 8

stage of atopic dermatitis:

-subacute to chronic

• erythematous papules, plaques with
  scale and excoriations
• posterior neck, antecubital and
  popliteal fossae

Answer 8

Childhood

Question 9

stage of atopic dermatitis:

• chronic dermatitis
• thickened hyperkeratotic plaques
• lichenification
• post-inflammatory hypo/hyperpigmentation
• usually extensor distribution
• hands may be quite extensive in severe
  cases

Answer 9

adult

Question 10

atopic triad

Answer 10

1. atopic dermatitis
2. asthma
3. allergic rhinitis

Question 11

food allergies common in atopic dermatitis?

Answer 11

yep

Question 12

why is there an increase in susceptibility to cutaneous viral and bacterial infections in atopic dermatitis?

Answer 12

due to the rupture of the vesicles

Question 13

diagnostic criteria for atopic dermatitis

Answer 13

1. itchy skin
2. skin creases/cheeks in children invovlment
3. asthma/hayfever
4. dry skin

Question 14

pathogenesis of the disrupted skin barrier function in atopic dermatitis

Answer 14

1. Structural abnormalities in the corneal layer lead to decrease in ability of the skin to retain water
2. Deficiency of ceramides (most important lipids in hydration of skin)
3. Filagrin defects (aids in stability/adhesion of corneocytes)

Question 15

treatment used in flares for atopic dermatitis

Answer 15

topical corticosteroids and calcineurin inhibitors

Question 16

maintenance for atopic dermatitis

Answer 16

1. keep skin hydrated
2. reducing bacterial colonies
3. systemic immunosuppresives

Question 17

• Inflammatory reaction of the skin caused by an exogenous substance
• 2 types
  - Irritant – direct toxic effect of the substance
  (e.g., acids, alkalis, solvents)
  - Allergic – an immunologic reaction is
  triggered by the substance (e.g, fragrances,
  metals, cosmetics, plants, medications)

Answer 17

contact dermatitis

Question 18

distribution of the contact dermatitis

Answer 18

linear, well demarcated that present with patches or plaques in area of exposure

Question 19

gold standard to test the difference between ACD and ICD

Answer 19

patch testing

Question 20

type of contact dermatitis:

non-specific inflammation from toxic injury to the skin

Answer 20

ICD

Question 21

type of contact dermatitis:

Cell-mediated Type IV immunologic response to a specific chemical

Answer 21

ACD

Question 22

• 7-10 days after exposure
  
  • chemical (hapten) combines with an epidermal protein and
    is presented by the antigen-presenting cell (Langerhan’s
    cell) to T cells
  • production of effector, memory and suppressor T cells

Answer 22

sensitization phase

Question 23

• 1-2 days after exposure in a previously sensitized individual
  
  • antigen presented to memory T cells by APC, causing them
    to activate
  • production of cytokines, recruitment of inflammatory cells

Answer 23

elicitation phase

Question 24

treatments of contact dermatitis

Answer 24

avoidance of irritant or allergen

Question 25

- An extremely itchy eczematous dermatitis that affects hands and feet - Vesicles present clinically and on histopathology - Most common in adults - Men=women

Answer 25

dyshidrotic dermatitis

Question 26

what do we see in dyshidrotic dermatitis

Answer 26

tapioca pudding like vesicles they usually appear on sides of fingers, palms and soles

Question 27

Pompholyx

Answer 27

Another name for dyshidrotic eczema; usually used when large bullae are present

Question 28

reaction to a distal dermatophyte infection

Answer 28

Id reaction

Question 29

- Eczematous eruption on the lower legs due to venous insufficiency - Men and women of middle and older age

Answer 29

stasis dermatitis

Question 30

what causes stasis dermatitis

Answer 30

venous hypertension that leads to capillary damage and leakage of RBS and serum

Question 31

treatment of stasis dermatitis

Answer 31

is to improve the venous circulation and to prevent edema

Question 32

- Chronic eczematous dermatitis that results from excessive scratching or rubbing - AKA – “neurodermatitis” - Pruritis may precede the scratching - Precipitated by stress and/or depression/anxiety - Predisposing factors: atopy, xerosis - Most common in adults - Some cases associated with OCD

Answer 32

lichen simplex chronichus

Question 33

what do we see in lichen simplex chronichus

Answer 33

hyperpigmented thickened leathery plaques found usually in the posterior neck

Question 34

treatment of lichen simplex chronichus

Answer 34

1. break the "itch-scratch" cycle | 2. treating psych issues