Inflammatory Dermatoses Flashcards
What are the key clinical features for allergic contact dermatitis?
- Linear or geometric shape
- Erythematous papules/plaques with or without vesicles or crusting
- Intense Itching
If you see a child with facial crusting and 1 eye closed shut, what do they most likely have?
Poison ivy
If you see someone with a pink plaque below their belly button, what is the most likely diagnosis?
nickel allergy to belt buckle
How should you work up a patient with allergic contact dermatitis?
Don’t do anything! (if the allergen is easily identifiable)
When should you do patch testing on a patient with allergic contact dermatitis?
Chronic contact dermatitis
Unknown allergy
What does patch testing help you do in allergic contact dermatitis?
Helps to identify and avoid allergens in chronic ACD
What are some common causes of allergic contact dermatitis?
Neomycin (topical antibiotics) Metals Rhus (poison ivy) Fragrances Preservatives Formaldehyde Rubber
How do you treat allergic contact dermatitis?
Topical Steroids
Stop contact allergen
When would you give oral steroids to a patient with allergic contact dermatitis?
if it was widely diffused–be sure to give for 2-3 weeks!! (or rebound can occur!)
Where do older children have atopic dermatitis?
Flexural surfaces (behind knees, behind neck)
Where do infants and toddlers have atopic dermatitis
Extensor surfaces: cheeks, ???
What are the common symptoms of atopic dermatitis? (the “must haves”)
Xerosis and pruritis
What is follicular prominence?
rough feeling–very close together bumps (very very hard to treat)
What is the most appropriate treatment for atopic dermatitis?
- Topical steroids
- Emollients (Vasalene)+ wrapping
- Eliminate staph aureus contamination (makes them more itchy!)
- Topical Calcineurin inhibitors (second line–steroid sparing)
Why do you not give oral steroids with atopic dermatitis?
works very well at first, but TERRIBLE rebound
How do you eliminate staph aureus contamination with atopic dermatitis?
bleach baths
What is a fairly common complication of atopic dermatitis (if they come into contact with herpes)?
eczema herpeticum
How do you treat eczema herpeticum?
IV Acyclovir
What are the key diagnostic features of urticaria?
No surface change (scale)
Erythematous, edematous papules and plaques (wheals)
Individual lesions last < 24 hours
What are the most common causes of acute urticaria?
Medicine or food allergy
How do you treat acute urticaria ?
1st and 2nd generation H1 antihistamines
If you see a patient with urticaria, what else must you consider?
anaphylaxis! (give epinephrine)
What are the clinical keys to fixed drug eruption?
- Very round “target-looking” mark with a central dusky purple area (that can become a blister)
- Usually comes every time patient takes the drug
- Heals with hyperpigmentation
What is the classic drug that gives you a fixed drug eruption?
laxatives
tetracyclines
NSAIDs
