Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics cabinetchip > Eczema and related dermatitis > Flashcards

Eczema and related dermatitis Flashcards

1
Q

aetiology of eczema

A

mutlifactorial both genetic and environmetal factors

-50% of severe cases have a mutationin the filaggrin gene

-this gene forms part of the strattum corneum which helps form the skin barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how is eczema diagnosed 2

A

clinically
-although total and specific IgE may be raised and aid diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

diagnostic criteria for eczema 4

A

flexural rash

development before the age of 2 (seen in 80%)

FHx

dry skin

allergic sensitation (total and specific IgE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

chief characterisitic of eczema 1

A

itch
-can be unbearable leeding to sleep loss,s tress and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

prinicples of eczema management

A

restoring the skin barrier

avoiding irritant and allergens

reducing inflammation

trying to reduce itch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can itching in eczema lead to 3

A

excoriation (which further disrupts the skin barrier)

infection

lichenifiication (thickening of the skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

barrier protection managemnt in eczema

A

bathe daily

use the greasiest emolloient tollerated (ointments)

-generally use a greasy emollient at night and cream during the day
-if greasy ointments are felt to be too messy for day time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

overview of priniciples of eczema managemnt 4

A

improving barrier

avoiding irritants and allergens

reducint in itch and scratchin

topical steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

prinicples of avoiding irritatns and allergens in eczema

A

these aggrevate eczema
-include soap perfumes and individualised allergens

heat and sweating aggrevates eczema so child and bedroom should be kept cool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

prinicples of reduction in itch and scratcing for eczema 4

A

dryness will contribute to itch so ensure well moisturied

sedative anti-histamines

cotton garmnets/scratch mits

keep nails schort

-scratching will cause release of histamiens and other chemicals into the skin which causes further ithcing (itch scratch cycle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when should topical steroids be used in eczema 2

for the following steroid potentencies give an example
mild
moderate
potent
very potent

A

short burts for active areas
-either flares only or additionally twice weekly if there are chronic pathces that do not clear

steroid potency
mild-hydrocortison (0.5-2.5%)

moderate betamethasone 0.025

potent Fluticasone 0.05

v potent clobetasol PROPIONATE 0.05

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

topical steroid regime for body in eczema

A

medium potency for 7 day for flares
-then 2-3 times weekly in chronic areas

*-if not controlled increase strength to a potent steroid again for short burts for flates then twice weekly for chronic patches- (if over 1yo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is safe topical steroid amounts for long term use in eczema

A

moderate and potetn topical steroids twice weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

topical steroid regime for eczema of the face

A

1% hydrocort safe for daily use
-except eyelids when use should be limited to 3 nights weekly

three day bursts of moderately potent steroids shouild be safe for occasionaly flares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

side effects of topical steroids in eczema 4

A

if used twice weekly moderate potency no side effects seen

fear of adverse affects has led to under use

others:
-systemic -cushings

-local- thinning, striae, telengectasia

-eyelids

-periorifical dermatitis

-steroid rosacea

-pustular psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common skin problem of infancy

A

irritant contact napkin dermatitis

17
Q

what causes irritant contact napkin dermatitis

A

moisture and friction disrups the skin barrier allowing penetration of irritants from urine and faeces

-contributed to by candida and bacterial overgrowth

18
Q

characteristic appearance of irritant contact napkin dermatitis 3

A

glazed eryhtmea that spares the skin folds

-can ulcerate if left untreated or when diarrhoea causes a sevee form

develops a wrinkled appearnace and scaling when it resolves

19
Q

treatment of mild irritant contact napkin dermatitis 2

A

frequent nappy changes w avoidiance of soap and wips

greasy emollients help repair skin barrier and a thick barrrier preparartion applied at each nappy change to prevenet prenetration of irritatns

20
Q

treatment of very inflamed irritant contact napkin dermatitis

A

topical steroid/antifungal cream to settle inflammation

try mild potency then moderate

use for 5-7days then repeat if flares <2x per mnth

if flares >2x mnth use twice weekly to chronic areas

21
Q

treatment of irritant contact napkin dermatitis if candidal infection develops

A

add topical antiyest - clotrimazole

CONTINUE USE OF STEROIDS

22
Q

appearnace of candida infected irritant contact napkin dermatitis

A

satellite papules and pusutles which spread to the flexures

23
Q

who gets vulvitis

A

young prepubertal girls

-represents localsied eczema

usually seen in atopic children (though may not have eczema elsewhere)

*-note prepubertal girls cannot develop candidiasis

24
Q

appearance of vulvitis

A

itch

eryhtmea

discharge

sting/buring passing urine

25
Q

managemnt of vulvitis

A

same as for napkin dermaitis
+
cotton underwear

avoidance of tights

26
Q

define discoid eczema

A

localised form of eczema

appears in well demarcated circular plaques
-often crusted and weeping due to bacterial superinfection

27
Q

management of discoid eczema 2

A

-potent steroid use is common
-usually start with medium strenght dependent on severeity
-use for 7-10 days to settle flairs

28
Q

management of discoid eczema 2

A

-potent steroid use is common
-usually start with medium strenght dependent on severeity
-use for 7-10 days to settle flairsr

29
Q

managment of discoid eczema if crusted/ weeping

A

if crusted/weeping
-topical steroid combinded with an antibacterial agent

30
Q

define lip lick dermatitis

A

peri-oral eczema caused by drying of the lips in atopic chldren

-causes them to lick them which then irriatets skin-> eczema-> viscouc cycle

usually worse in winter

31
Q

managemtn of lip lick dermatitis 3

A

greasy emollients

if red-> topical steroid with an anti yeast
-daktacort (weak steroid) for 7 days

trimovate (moderate steroid) for 2 days for flares

if requirng trimovate more than once per month-> consider tacrolimus

32
Q

appearance pityriasis alba

A

usually asain children

hypopigmentation
-usualy with dry rough skin on cheekcs of atopic children 4-12 years
-seen mainly in non-caucasian skin

genetrally patchy and poorly demarcated inconrast to vitligo

33
Q

Management of pityriasis alba 3

A

use of emollients

topical streoids to areas of erythema

and sunscreen to prevent surrouding skin tannign whichc makes it more obvious

34
Q

who gets juvenile plantar dermatosis

A

affects anterior planter surface of children (mainly boys)
aged 4-7

flares intermittently continues until puberty then settles spontaneously

main trigger is sweating
-variety of factors contribute
-wearing of sports shoes with rubebr soles and syntehtic nylon (football) socks or tights whichc cause occulsion and maceration

35
Q

risk factors for juvenile plantar dermatosis 2

A

repeated friction

atopic dermatitis

-worse in winter

36
Q

where on the foot is affeected by juvenile plantar dermatosis (more specific)

-appearance 3

A

plantar surface of the anterior third of the foot and occasionally the first toe
-plantar arch is always spared

-erythema
-hyperkeratosis
-fissuring
-characteristic glazed appearanc

(itch is not a feature)

37
Q

investigations for juvenile plantar dermatosis

A

clinical diagnosis

patch testing- though ont routinely recommened

rubber allergy- may affect soles and palms but is usually itchy and generally causes blisters- JPD does not

38
Q

treatment for juvenile plantar dermatosis 5

A

avoid occlusive footwear and synthetic socks

wear 2 pairs of cotton socks or thick toweling socks to imrpove aborption of sweat

aluminium hydrochldoird powder may help reduce sweating

urea based emollients may help hyperkeratosis and fissusing

topical steroids for flares

Paediatrics cabinetchip (80 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions