Contact Dermatitis

Question 1

Irritant Dermatitis

Answer 1

caused by an agent acting an an irritant

Question 2

Contact Dermatitis

Answer 2

caused by an allergen

Question 3

Photophytodermatitis

Answer 3

inflammatory rxn due to exposure of a topical or oral photsensitizer followed by UV wavelength

Question 4

Rhus dermatitis

Answer 4

inflamm rxn due to contact with a planet

Question 5

Epidemiology of contact derm and irritant derm

Answer 5

occupation, leisure activities, hobbies play a factor in both

Question 6

ACD

Answer 6

delayed hypersensitivity response which requires a prior sensitization. Once sensitied, only a small amount of offending substance is needed to cause an allergy

Question 7

ID

Answer 7

irritant disrupts the skin permeability, mild damage occurs to keratinocytes causing inflammatory mediators , can be acute or chronic like frequent hand washing

Question 8

Clinical features ACD

Answer 8

Shape, location and pattern are important: well demarcated eczematous eruption, extremely pruritic. Acute phase: erythematous weepy skin with vesicles and bullae. Chronic: lichenification, erythematous plaques

Question 9

Clinical Features: ID

Answer 9

NOT well demarcated, erythematous scaling, prominent lichenification, stinging is more common than pruritus

Question 10

Dermatopathology ACD

Answer 10

Spongiotic dermatitis with mixed inflammatory infiltrate with lymphocytes, histiocytes and eosinophils

Question 11

ID Dermatopathology

Answer 11

mild spogiosis with inflammatory infiltrate. Necrosis of epidermal keratinocytes.

Question 12

Top Allergens

Answer 12

nickel, balsam of peru, fragrance, neomycin sulfate, bacitracin, formaldehyde, cobalt chlorida, black dye

Question 13

Allergens can be found in

Answer 13

preservatives, rubber, textiles, adhesives, cosmetics, hygeine products

Question 14

Allergens for ID

Answer 14

Acids, metal salts, solvents, disinfectants, chronic water exposure, alcohol, plastics, body fluids like in lip lickers and diaper derm

Question 15

ACD Patch Testing

Answer 15

True test: 36 pre-impregnated allergens on 3 panels on the patients back. Keep dry. Remove in 48 hours can interpret then and again in 72 hours. Again at one week. + = erythema and bullous rxn

Question 16

Tx for ACD and ID

Answer 16

Avoiding offensive substance, pt ed on reading ingredient labels. Skin protection with emollients and cotton gloves. Corticosteroids for inflammation, Oral antihistamine to decrease urge to scratch

Question 17

onset of ID is

Answer 17

gradual

Question 18

onset of ACD is

Answer 18

rapid

Question 19

borders with ID

Answer 19

indistinct

Question 20

borders with ACD

Answer 20

clear areas of demarcation

Question 21

Rhus dermatitis

Answer 21

contact w poison ivy, poison oak, poison sumac. 3 leaflets.

Question 22

Rhus derm patho

Answer 22

urushiol oil = alergic reaction on the skin

Question 23

Clinical s/s rhus derm

Answer 23

linear pattern of erythema causing vesicles and bullae, extreme pruritis. exposure to smoke from burning ivy will cause wide spread erythematous plaques and edema

Question 24

tx Rhus dermatitis

Answer 24

burrows solution to dry vesicles. antihistamines, calamine to help with itch and weepy lesions to dry, topical steroids in a gel to help dry lesions, oral steroid if severe

Question 25

Photophytodermatitis

Answer 25

fennel, celery, parsnip, parslep, lime, orange, lemon, grapefruit.

Question 26

At risk for Photophytodermatitis

Answer 26

employment with fruit and vegetable processing, bartenders working outdoors, people making lemonade/limeade, gardeners.

Question 27

pathogenesis Photophytodermatitis

Answer 27

plants with Furoocumarins that protect the plant from fungal attacks followed by UV causes skin injury

Question 28

Clinical signs Photophytodermatitis

Answer 28

erythema, edema, bullae in bizarre pattern 24-48 hrs after exposure. not painful, not pruritic. Hyperpigmentation after can remain for months to years

Question 29

tx Photophytodermatitis

Answer 29

prevention is key, rapid washing of skin immediately after exposure may prevent a reaction, high potent topical steroids can decrease intensity of rxn and reduce PIH