Inflammatory Skin Disease Flashcards
What is the typical age of onset for atopic dermatitis?
5 years of age
What are the three stages of atopic dermatitis?
Infantile, childhood and adult
What are the diagnostic criteria of atopic dermatitis?
Itchy skin +
Three or more of the following:
1. History of involvement of skin creases
2. Personal history of asthma or hay fever
3. History of dry skin within the last year
4. Visible flexural eczema
5. Onset under 2 years of age
Is irritant contact dermatitis immunologically mediated?
No it is a result of direct cytotoxic effects
True or false: Irritant contact dermatitis is the most common type of contact dermatitis.
True
Define strong irritants.
They are irritants that can damage skin directly even in small amounts and over short periods of time they usually come with some kind of warning.
Give an example of a strong irritant.
Acid
Define and give an example of a weak irritant.
Weak irritants are harmless but cause irritation over multiple exposures. They include wool, soap and water, skin products
How can you recognize irritant contact dermatitis?
Look for distribution pattern.
Is allergic contact dermatitis immune mediated?
Yes. It involves exposure to an allergen, immune response and memory T cells.
What type of immune reaction is allergic contact dermatitis categorized?
It is type IV delayed-type hypersensitivity reaction.
What causes the most allergic contact dermatitis cases?
Nickel. You can test using dimethyglyoxine test
What are the two topical antibiotics that cause the most cases of allergy contact dermatitis cases?
- Neomycin sulfate
2. Bacitracin
What is the clinical presentation of seborrheic dermatitis?
Sharply demarcated patches with pink or slightly orange-yellow erythema. Can be flaky, greasy scales. Occurring in areas that are rich in sebaceous glands.
Where is seborrheic dermatitis found in adults?
Scalp, medial eyebrows, nasolabial folds, and ears,
What disease has a common mobidity with seborrheic dermatitis?
Parkinson’s disease
How does seborrheic dermatitis look in infants?
“Cradle cap” beginning one week after birth. Thick scales covering most of the scalp and often seen in the inguinal folds or axillae.
What causes seborrheic dermatitis?
Malassezia furfur. Normal part of the flora that becomes imbalanced. Found in areas of active sebaceous glands
What bacteria is greatly reduced in seborrheic dermatitis?
P. acnes
What is the treatment for seborrheic dermatitis?
Ketoconazole cream
Ketoconazole shampoo
Hydrocortizone cream (infants)
What is the cause of stasis dermatitis?
Chronic venous insufficiency of the lower extremities associated with lower extremity edema.
What can complicate stasis dermatitis?
other skin conditions
What is the treatment for stasis dermatitis?
compression, elevation, exercise calf muscles, vascular surgery, topical steriods, and avoiding allergens.
What does lichen simplex chronicus look like?
Thick, scaly plaques that result from chronic rubbing and scratching
What is the treatment for lichen simplex chronicus?
Topical steriods and antihistamines for itching
Where are venous stasis ulcers usually located?
Medial lower leg
When do venous stasis ulcers become purulent?
When infected
Where do nummular eczema usually appear?
The legs of men over fifty. They are red, scaly and become crusty
What is the treatment for nummulary eczema?
Moisturization and topical corticosteriods
Epidemiologic studies have shown that in psoriasis patients associated disorders occur more frequenly than expected. Name some of these associated disorders.
Arthritis, Crohn’s disease. insulin resistance, obesity, metabolic syndrome, Cardiovascular disease
Name some localized treatments for psoriasis.
Calcipotriol, corticosteriod, and phototherapy
Name some systemic treatments for psoriasis.
Methotrexate, cyclosporin, systemic retinoids,
What is the cause of most cases of exanthematous eruptions in adults?
Drugs like aminopenicillin, sulfonamides, cephalosporins, etc.
What enhances the risk of a exanthematous eruption due to drugs?
Viral infection
What is the treatment of exanthematous eruption?
Stop taking the offending agent and antihistamines or pruritus
What type immune reaction is urticaria?
Type 1 hypersensitivity reaction mediated by IgE antibodies. .
What are the two categories of urticaria?
Acute= less than 6 weeks Chronic= more than 6 weeks
What is used to treat urticaria?
Antihisamines for pruritus
What preservatives cause a lot of allergy contact dermatitis?
Formaldehyde, quatenium-15
Cheat sheet: Location
Stasis dermatitis – lower extremity edema
Seborrheic dermatitis – Malassezia furfur
Atopic dermatitis – Filaggrin
Irritant dermatitis – Common irritants
Allergic contact dermatitis – Common allergens
Cheat sheet: Etiology
Stasis derm – lower legs
Seborrheic dermatitis – scalp
Atopic dermatitis – Flexor surfaces
Psoriasis – Extensor surfaces, may include arthritis
Cheat Steet: Miscellaneous Facts
Atopic dermatitis – Associated with Asthma and Allergic rhinitis
Allergic contact dermatitis – Delayed type hypersensitivity reaction (Type IV); Diagnosis confirmed with patch testing.
Psoriasis – May be associated with increased risk of cardiovascular disease
