Dermatits and Urticaria

Question 1

Symptoms of dermatits

Answer 1

Rash can be scaly, skin typically dry
Usually itchy
Can effect anywhere on the body
Can be acute/chronic or both with permanent areas of dry, itchy skin and intermittent acute flares.

Question 2

Symptoms of Urticaria

Answer 2

Patches of well-demarcated, superficial, erythematous skin swelling that can vary from a few millimeters to man centimetres in diameter.
Superficial weals are usually itchy
Angioedema can be itchy, painful, burning or tender
Can effect any area of the body
Acute> last for a few hours to 6 weeks
Chronic > lasting for 6 weeks

Question 3

When to refer

Answer 3

Diagnosis is unclear
Secondary infection
Signs of systemic infection (fever)
Respiratory, gastrointestinal, cardiovascular, symptoms are also present.

Question 4

When to refer - dermatitis specific

Answer 4

Symptoms are widespread,
Symptoms are severe
Sensitive areas

Question 5

When to refer - urticaria

Answer 5

Angioedema is present
Weals are not transient
An underlying condition is suspected

Question 6

Dermatitis treatment options

Answer 6

Moisturisers, topical corticosteroids, other tropical therapies, systemic therapies.

Question 7

Moisturisers

Answer 7

Emollient or humectants.
Apply twice daily preferably after showering/bathing

Question 8

Topical Corticosteroids

Answer 8

Low Potency - hydrocortisone
Medium Potency - Clobetasone Butyrate
High Potency - Monetasone Furoate
For pregnancy: use low-mild especially in first trimester
Breastfeeding - Safe during breastfeeding however will need to wipe off on nipple area.
Apply once daily.

Question 9

Urticaria treatment options

Answer 9

First line: anti-histamine (loratadine)
If anti-histamines are not effective then H2 receptors can be used (famotidine)

Question 10

Fingertip method

Answer 10

1 fingertip should cover an area equivalent of the front and back of a patients band.

Question 11

Moisturiser product type

Answer 11

Cerave moisturising cream, cetaphil moisturising cream.

Question 12

Non-pharmacologcial

Answer 12

Avoid overheating the skin
Wear preferably 100% cotton.
Avoid chlorinated pool.
Bathe in lukewarm water
Avoid SLS
Apply moisturiser.
Patch test
Avoid fragranced products.

Question 13

Dermatitis causes

Answer 13

Soaps
Chemicals
Abrasive fibres
Plants
body fluids
allergens such as house dust mites, grasses and pollens, animal dander, chemicals

Question 14

Urticaria

Answer 14

Infection - likely viral upper respiratory
Drug allergy - NSAIDS, antibiotics, sulfoanamides
IgE mediated food rection
Insect Stings
Contact with certain substances.