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eczmetaous dermatitis Flashcards

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Dermatology Board Prep flashcards
1
Q

what is dermatitis

A

inflammation of the skin

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2
Q

Eczematous dermatitis may be:

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

All eczematous dermatitides are characterized by ________ or epidermal intercellular edema

A

“spongiosis”

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4
Q

One cannot distinguish between different types of eczematous dermatitis on biopsy

A

yep so true

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5
Q 
Irregular epidermal
hyperplasia is more 
pronounced
 Spongiosis 
is subtle
A

chronic spongiotic dermatitis

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6
Q
  • 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
A

atopic dermatitis

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7
Q

stage of atopic dermatitis:

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

infantile

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8
Q

stage of atopic dermatitis:

-subacute to chronic

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

Childhood

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9
Q

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
A

adult

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10
Q

atopic triad

A
  1. atopic dermatitis
  2. asthma
  3. allergic rhinitis
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11
Q

food allergies common in atopic dermatitis?

A

yep

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12
Q

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

A

due to the rupture of the vesicles

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13
Q

diagnostic criteria for atopic dermatitis

A
  1. itchy skin
  2. skin creases/cheeks in children invovlment
  3. asthma/hayfever
  4. dry skin
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14
Q

pathogenesis of the disrupted skin barrier function in atopic dermatitis

A
  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)
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15
Q

treatment used in flares for atopic dermatitis

A

topical corticosteroids and calcineurin inhibitors

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16
Q

maintenance for atopic dermatitis

A
  1. keep skin hydrated
  2. reducing bacterial colonies
  3. systemic immunosuppresives
17
Q
  • 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)
A

contact dermatitis

18
Q

distribution of the contact dermatitis

A

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

19
Q

gold standard to test the difference between ACD and ICD

A

patch testing

20
Q

type of contact dermatitis:

non-specific inflammation from toxic injury to the skin

A

ICD

21
Q

type of contact dermatitis:

Cell-mediated Type IV immunologic response to a specific chemical

A

ACD

22
Q
  • 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
A

sensitization phase

23
Q
  • 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
A

elicitation phase

24
Q

treatments of contact dermatitis

A

avoidance of irritant or allergen

25
Q
  • An extremely itchy eczematous dermatitis that affects hands and feet
  • Vesicles present clinically and on histopathology
  • Most common in adults
  • Men=women
A

dyshidrotic dermatitis

26
Q

what do we see in dyshidrotic dermatitis

A

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

27
Q

Pompholyx

A

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

28
Q

reaction to a distal dermatophyte infection

A

Id reaction

29
Q
  • Eczematous eruption on the lower legs due to venous insufficiency
  • Men and women of middle and older age
A

stasis dermatitis

30
Q

what causes stasis dermatitis

A

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

31
Q

treatment of stasis dermatitis

A

is to improve the venous circulation and to prevent edema

32
Q
  • 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
A

lichen simplex chronichus

33
Q

what do we see in lichen simplex chronichus

A

hyperpigmented thickened leathery plaques found usually in the posterior neck

34
Q

treatment of lichen simplex chronichus

A
  1. break the “itch-scratch” cycle

2. treating psych issues

derm (10 decks)

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