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Course 2 - Dermatology > Eczema + Topical steroids > Flashcards

Eczema + Topical steroids Flashcards

1
Q

dermatitis vs. eczema

A

eczema is defined by:

spongiotic dermatitis

red scaling patches

itch

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2
Q

define spongiosis

A

intercellular edmea

peri-vascularlymphocytic inflammation in dermis

reaction pattern of:

  1. lymphocytes following vascular pattern
  2. stretching of intracellular bridges
  3. collection of fluid from intraepidermal edema
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3
Q

clinical pattern of acute eczematous reactions

A

morphology: papules, vesicles, plaques, bulla

secondary morphology: excoriations, erosions, crusts

clinical features: vesiculation visible clinically

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4
Q

clinical features of sub-acute eczematous reactions

A

morpholoy: plaques

secondary morphology: crusts, erosions, excoriations

clinical features: inflammation less than acute, intercellular edema results in weeping erythematous plaque

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5
Q

clinical features of chronic eczema

A

morhology: plaques

secondary morphology: lichenification, scaling, erosions, fissues

clinical: dry red scaling plaques, lichenified (prominent skin folds, thickening of epidermis), chronic irritation from rubbing

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6
Q

dermatitis in a linear pattern often means an _____ etiology

A

exogenous/external

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7
Q

most common hapten to cause ACD

A

nickel

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8
Q

what is this a presentation of?

A

seborrheic dermatits

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9
Q

describe the presentation of seborrheic dermatitis

A

morphology: patch

secondary morphology: scale

clinical features: erythema and scaling in sebum rich areas of face

greasy, bran-like scaling

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10
Q

seborrheic dermatitis has a link to commensal yeast called

A

malassezia

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11
Q

epi of seborrheic dermatitis

A

M > F

most common form of eczema

adults and infantile form

adult peak 4-6th decade

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12
Q

cradle cap is a form of ______

A

seborrheic dermatitis

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13
Q

what is this a presentation of?

A

nummular dermatitis

morphology: plaque

secondary morphology: erosions, crusts, excoriations

clinical features: sub-acute eczema, coin shaped eczematous lesions which may be widespread

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14
Q

what is this a presentation of?

A

stasis dermatitis

morphology: sub-acute or chronic eczema

clinical fearures: eczematous eruption seen in association with lower leg edema, control underlying edema with compression garments

topical steroids

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15
Q

describe asteatotic dermatitis/xerosis

A

morphology: patch

secondary morphology: scale

result of external and internal causes, aging is most common cause, dry climate with low himidity, exposure to water and soap

desiccation of stratum corneum results in small cracks, stinging and itching sensation

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16
Q

atopic dermatitis typically begins in _____ and has Fx of ______

A

infancy/early childhood

hay fever

17
Q

morphology of atopic dermatitis lesions

A

acute, sub-acute, or chronic pattern of eczema may be seen

infantile: face and extensor extremities

older children: felxures, antecubital and popliteal fossae

18
Q

what is this a presentation of?

A

pomphylx

pattern of hand dermatitis where small vesicles are seen on fingers/palms

19
Q

what is the therapeutic ladder for AD

A

avoidance of triggers

basic care for dry skin

topical anti-inflammatory agents

phototherapy

systemic therapy with immuno-suppressive, biologic, and anti-inflammatory therapy

20
Q

most children outgrow food triggers for AD T/F

A

T

21
Q

What is the risk from overuse of topical steroids?

A

atrophy

22
Q

what is an advantage/disadvantage of calcineurin inhibitors?

A

indicated for skin at high risk of atrophy such as face, body folds

risk of malignancy from chronic use, side effect of skin irritation

23
Q

what are two sedating antihistamines used to reduce pruritus?

A

diphenhydramine, hydroxyzine

24
Q

ointments use _____ vehicles and are ______ potent

A

petroleum jelly, more potent

best at delivering drug

least irritating

25
Q

indications for lotion as a vehicle

A

easy to apply

poured or pumped out of bottle

very irritating

less potent than oiuntment

26
Q

describe gels as a vehicle

A

easiest to use for hairy skin

irritating to broken skin, can have drying effect

27
Q

side effect of steroids

A

atrophy

opthamologic complications

striae distensae

exacerbation of periorificial dermatitis

steroid acne

28
Q

dosage for steroid cream (grams, how much to prescribe)

A

3g each for head/face and arm

6g for a leg

9-12g for the trunk

30g for whole body once

29
Q

when do you use weak steroids (hydrocortisone cream)

A

face

body folds

30
Q

when do you use mid-potency (betamethasone 0.1%)?

A

torso, arms, legs

31
Q

when do you use high-potency (clobetasol 0.05%)?

A

pams and soles

32
Q

when should you stop using steroid creams?

A

48 hours after itching stops

psoriasis –> chronic use

Course 2 - Dermatology (11 decks)

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