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2A week 3 - eczema, psoriasis and infections > intro to derm > Flashcards

intro to derm Flashcards

1
Q

6 common problems seen in derm

A
  1. skin cancers - common cause of death in YA;
  2. inflammatory disorders (eczema, psoriasis etc.);
  3. acne;
  4. inherited/childhood skin disease;
  5. skin infections;
  6. pigment, hair and nails disorders
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2
Q

what is eczema

A

a term used to describe a collection of diseases that have similar presentation (itchy, dry, red) and maye co-exist with eachother - including atopic eczema (majority), allergic contact eczema, discoid, varicose eczema etc.

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3
Q

eczema vs dermatitis

A

all eczema is dermatitis (but not all dermatitis is eczema)

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4
Q

what is the atopic triad

A

asthama, eczema, allergic rhinitis (e.g. hayfever)

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5
Q

what are some consequences of eczema itch

A

loss of sleep, loss of concentration, anger, may not be able to do their job

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6
Q

what are Pompholyx

A

a type of eczema which affects the hands and feet, causing tiny blisters and irritation

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7
Q

erythroderma vs suberythroderma

A

erythroderma - greater than 90% body surface area involved
suberythroderma - 70-90% of body surface area involved

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8
Q

what is follicular eczema

A

eczema around the hair follicules

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9
Q

what causes the erythema in eczema

A

diversion of blood to skin due to inflammatory cytokines or more translucent skin -> may result in increased heat loss and increased itching

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10
Q

what causes scale in eczema

A

excessive production of epidermis which peels off or stays stuck to the top layer so become thick - hyperkeratosis

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11
Q

what causes lichenification in eczema

A

thickened hyperkaeratotic skin due to rubbing with more lines/wrinkles

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12
Q

functions of the skin

A
  1. thermoregulation;
  2. physical barrier (infection, allergens, waterproofing)
  3. key strucutre for body
  4. vit D synthesis
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13
Q

what is responsible for the waterproofing of the skin

A

oily (waxy) layer produced by seebum

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14
Q

where might babies present with eczema

A

face

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15
Q

what are the typical site for eczema to present

A

flexures - creases of arms, knees, wrists

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16
Q

what is a common reason for treatment failure in derm

A

“steroid-phobia” - many people wont use steroids as they worry about side effects

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17
Q

side effects of hydrocortisone

A

thin skin (rare)

18
Q

steroid potencies + examples

A
  1. mild e.g. 1% hydrocortisone;
  2. medium e.g. emovate;
  3. potent e.g. betnovate
  4. very potent e.g. dermovate
19
Q

what can occur if wrong potency of steroids is used

A

too weak - increased suffering, no treatment progression
too strong - skin thinning, possibly cushings (unlikely unless repeat of very potent steroids)

20
Q

what causes asteatotic eczema

A

lack of oil on the skin - usually if in hosptial/nursing home

21
Q

features of asteatotic eczema

A

cracking of skin, like a dry river bed

22
Q

treatment for asteatotic eczema (3)

A
  1. bathe less often/for shorter periods of time and use cooler water;
  2. use less detergent;
  3. apply oil to skin
23
Q

where does irritant contact eczema usually occur

A

the hands

24
Q

why is history essential in diagnosing the eczema type

A

many eczemas look the same - may be difficult to differntiate between allergic, irritant and atopic eczema based on examination alone

25
Q

irritant contact vs allergic contact eczema

A

irritant - arises due to chemicals that irritate skin cells;
allergic - arises due to an immune process

26
Q

common causes of allergic contact eczema (6)

A
  1. nickle
  2. fragrances (on perfumes etc.)
  3. rubber accelerators
  4. chromate
  5. formaldehyde
  6. plants
27
Q

how can allergic contact eczema be tested

A

patch testing

28
Q

where might varicose eczema occur

A

on the lower legs, around varicose veins

29
Q

what might cause varicose eczema

A

leaking of irritants from stagnant blood stuck in the veins -> likely neutrophils

30
Q

treatments for varicose stasis (and thus varicose eczema) - 6

A
  1. loose weight - associated w obesity
  2. exercise
  3. elevate legs
  4. avoid standing/sitting for long periods
  5. compression bandages
  6. varicose vein surgery
31
Q

what phsyical barrier can be implemented for eczema and when should it not be used

A

bandages; should not be used if eczema is infected

32
Q

what bacteria commonly causes infection in eczema (post sractching)

A

staph aureus

33
Q

presentation of staph infected eczema

A

yellow/golden crusts or blisters of impetigo

34
Q

treatment for herpes simplex eczema infection

A

aciclovir

35
Q

how to distinguish discoid eczema from psoriasis

A

has vesicles and lacks psoriasis scale

36
Q

what casues discoid eczema and how is it treated

A

caused by bacterial infection of eczema; treated w Abx or antiseptic/steroid combinations

37
Q

what causes seborrhoeic eczema and what area is is commonly seen in

A

sensitivity to yeast on skin (not in diet); commonly seen around nose, eyebrows, flexures

38
Q

how to treat seborrhoeic dermatitis

A

topical antifungals

39
Q

what should be considered (to test for) if someone presents with severe sebborhoeic dermatitis

A

HIV

40
Q

what non-topical treatments can be offered for eczema (treatments not working)

A
  1. local PUVA - UVA phototherapy (psorellan), usually just hands of feet;
  2. oral alitretinoin (retinoid);
  3. oral azathioprine, ciclosporin (broad spectrum immunosupression)
41
Q

differentials for eczema (5)

A
  1. scabies - check if family/close contacts present with the same symptoms
  2. fungal infection of hands - usually unilateral
  3. psoriasis - likely to have nail changes, not usually itchy
  4. drug eruption
  5. rarer diseases e.g. mycosis fungoides
42
Q

Fitzpatrick skin types (6)

A

I Pale white skin, blue/green eyes, blond/red hair -Always burns, does not tan
II Fair skin, blue eyes - Burns easily, tans poorly
III Darker white skin - Tans after initial burn
IV Light brown skin - Burns minimally, tans easily
V Brown skin - Rarely burns, tans darkly easily
VI Dark brown or black skin - Never burns, always tans darkly

2A week 3 - eczema, psoriasis and infections (6 decks)

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