Topic I/5) Dermatitis- Eczema- group, clinical forms and therapy

Question 1

phases of eczema-dermatitis

Answer 1

1. Acute phase – vesicles or bullae
2. Subacute phase – skin can be erythematous, dry/flaky, edematous and crusted
3. Chronic, persistent phase – characterized by thickened or lichenified skin

Question 2

which layers of skin are involved?

Answer 2

dermis and epidermis

Question 3

Classification of eczema:

Answer 3

1.endogenous

atopic,discoid,hand.seborrheic,venous,asteatotic
2.exogenous
contact(allergic),contact(irritant),photosensitive,lichen simplex

Question 4

discoid eczemas

Answer 4

well demarcated scaly patches

on limbs

Question 5

Hand eczema

Answer 5

Itchy vesicles or blisters of the palms and along sides of fingers (pompholyx)
• A diffuse erythematous scaling and hyperkeratosis of the palms
• A scaling and peeling most marked at the fingertips

Question 6

Seborrhoeic eczema

Answer 6

due to overgrowth of the fungus Pityrosporum ovale (aka. Malassezia furfur in its hyphal form) combined with a strong cutaneous immune response to this yeast fungus which produces the characteristic inflammation and scaling seen.

Question 7

dandruff

Answer 7

Mild cases of seborrheic eczema of the scalp

Question 8

cradle cap

Answer 8

Seborrheic eczema of the scalp of newborns

yellowish, greasy, thick crusts on the scalp

Question 9

treatment of seborrhoeic eczema

Answer 9

1%hydrocortisone
topical antifungal cream(miconazol)
tacrolimus
ketoconazole shampoo(dandruf)
arachis oil

Question 10

Venous (gravitational/varicose) eczema:

Answer 10

in the lower legs (esp. ankles) due to chronic venous
hypertension.
venous hypertension may cause endothelial hyperplasia and extravasation of erythrocytes and leukocytes which in turn cause inflammation, purpura and pigmentation (hemosiderin deposits)
History commonly reveals past venous thrombosis or surgery for varicose veins.

Question 11

treatment of venous eczema

Answer 11

topical steroids
emollients
support stockings
compression bandages
leg elevation

Question 12

Asteatotic eczema („winter”/ „senile” eczema)

Answer 12

dry, plate-like cracking of the skin with a red, eczematous component which
occurs in elderly people
It occurs predominantly on the lower legs and on the back of hands

Question 13

causes of the asteatotic eczema

Answer 13

excessive use of soaps (loss of stiatum corneam lipid)

myxedema and diuretic therapy

Question 14

Allergic contact eczema

Answer 14

after reapeted exposure
type 4 hypersensivity
stimulants: nickel,chromate,latex,perfume,plants

Question 15

Irritant contact dermatitis

Answer 15

ccur after repeated direct exposures to irritants such as detergents, soaps or bleach

Question 16

photosensitive eczema

Answer 16

distribution over the face, neck and hands. Pre-existing eczema may be present, and it may spread to sites not exposed to sunlight, thus complicating a precise diagnosis.

Question 17

Lichen simplex

Answer 17

cutaneous response to scratching or rubbing in the abscence of an underlying dermatosis
hickened, scaly and hyperpigmented areas of lichenification with intense pruritus that become tender upon rubbing

Question 18

nodular prurigo

Answer 18

itchy papules and domed nodules.