November 30, 2015 - Dermatitis Flashcards
Dermatitis: Definition
An inflammatory response of the skin induced by a wide range of external (exogenous) and internal (endogenous) factors acting singly or in combination.
Synonymous with eczema
Dermatitis: Clinical Features
Itching
Indistinct border
Erythematous papules and plaques
Vesicles
Scaling
Excoriations
Lichenification
Distribution of Acute Dermatitis
Infancy - scalp, face, extensor extremities… but usually spares the diaper region
Childhood - flexural areas
Adulthood - flexural areas, hands, face, nipples
Atopic Dermatitis: Lab Findings
Eosinophilia
Increased IgE in 80% of patients
Treatment of Atopic Dermatitis
Topical corticosteroids
Topical calcineurin inhibitors
Oral antihistamines
Antibiotics
Bleach baths
Phototherapy
Topical Calcineurin Inhibitors
Selectively inhibit T-cell activation in the skin.
Does not cause skin atrophy.
Second line therapy because of long-term safety and cost.
Atopic Dermatitis: Complications
Bacterial infections - S. aureus
Viral infections - HSV, HPV, molluscum
Fungal infections
Mental and emotional dysfunction
Seborrheic Dermatitis
A subacute or chronic dermatitis of unknown cause typically confined to sebaceous gland-rich skin of the head and trunk, but occasionally involving other areas.
Often yellow stuff.
Seborrheic Dermatitis: Treatment
Daily shampooing with shampoos containing… ketoconazole (anti-fungal), zinc pyrithione, selenium sulfide, cicopirox, coal tar, salicylic acid.
Anti-fungal creams
Mild topical steroids
Topical calcineurin inhibitors
Stasis Dermatitis
A common inflammatory dermatitis of the lower extremities occuring in patients with chronic venous insufficiency.
Valvular dysfunction results in backflow of blood from deep venous system to superficial venous system, leading to venous hypertension.
Medial ankle is most frequently involved, and the colour is often a reddish-brown discolouration from hemosiderin.
Stasis Dermatitis: Treatment
Compression therapy
Topical corticosteroids
Bland emollients
Asteototic Dermatitis
Eczema craquele
Pruritic, dry, cracked and poygonally fissured skin that resembles a “dried riverbed”
Shins are most commonly afflicted, followed by the lower flanks.
Often occurs in the elderly.
Irritant Contact Dermatitis
An inflammatory process which follows exposure to an exogenous agent(s) that injures the skin at the site of contact.
Non-immunologically mediated. No previous exposure is necessary. A direct cytotoxic effect due to a single or repeated application of a chemical substance to a cutaneous site.
Irritant Contact Dermatitis: Treatment
Limit exposure to irritants
Emollients
Mild topical steroids
