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Dermatology > Dermatitis > Flashcards

Dermatitis Flashcards

1
Q

What are the two phases of dermatitis?

A

Acute and chronic

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2
Q

State the features of the acute phase

A
  • papulovesciular
  • erythematous lesions
  • oedema
  • ooze/scale/crust
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3
Q

State the features of the chronic phase

A
  • lichenification
  • elevated plaques
  • increased scaling
  • risk of infection
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4
Q

What is the typical clinical sign of dermatitis?

A

itchy, ill defined erythematous, scaly patches

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5
Q

Name the different types of dermatitis

A
  • contact allergic dermatitis
  • irritant contact dermatitis
  • atopic eczema
  • discoid
  • photosensitive
  • seborrhoeric
  • pampholyx
  • eczema herpeticum
  • lichen simplex
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6
Q

What is the pathology of contact allergic dermatitis on first exposure?

A

Type 4 hypersensitivity reaction where langerhans cells in the epidermis process an antigen and bind the antigen to MHC class II this cell travels to the lymph nodes to activate T cells - T cells then release cytokines which active macrophage leading to proliferation of allergen specific memory T cells

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7
Q

What happens on future exposure in contact allergic dermatitis?

A

T cells migrate to the site and cause inflammation

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8
Q

How is contact allergic dermatitis diagnosed?

A

Delayed hypersensitivity using patch test

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9
Q

How is contact allergic dermatitis treated?

A

Identify and avoid allergen

Steroids may be used to treat a flare

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10
Q

What is irritant contact dermatitis?

A

Non-specific physical irritation as a result of toxic effect of an irritant, strips the oils off the hand leading to symptoms

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11
Q

What are common irritants that cause ICD?

A

Soap, oil cleaning products

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12
Q

Where does ICD commonly occur?

A

Hands and finger web spaces

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13
Q

What is meant by atopic?

A

Word used to describe a group of diseases (asthma, eczema, hay fever and food allergy), that result from a tendency to develop hypersensitivity to allergens

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14
Q

What causes atopic diseases?

A

Genetic predisposition in addition to environmental factors

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15
Q

Describe the pathogenesis of acute atopic eczema

A

TH2 cells are activated by the presentation of antigens by langerhans cells to CD4+ cells in the dermis. TH2 cells release interleukin 4, 5, & 13 which recruit B cells and eosinophils. The B cells make IgE leading to mast cell degranulation.

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16
Q

Describe the pathogenesis of chronic atopic eczema

A

Eosinophils release IL-12 activating TH1 leading to the release of IFN alpha by CD4 and CD8 T cells

17
Q

Most cases of atopic eczema have unknown aetiology but what may some be due to?

A

Mutations in the filaggrin gene which leads to a deficiency and thus a leaky skin barrier which allows excess water loss and dry skin

18
Q

What are the symptoms of atopic eczema?

A

Generalised dry skin, itch, ill defined erythema and scaling. Flexural distribution.

19
Q

Which infection is common in people with eczema?

A

Staph aureus

20
Q

State the diagnostic criteria for atopic eczema

A 
itch plus 3 or more;
visible flexural rash 
history of flexural rash 
history of atopy 
dry skin 
onset < 2years
21
Q

How is atopic eczema treated?

A 
Emollients 
Avoid irritants 
Topical steroids for flare ups 
Phototherapy 
Topical Immunosuppressants
Systemic treatment 
Biologics
22
Q

What topical immunosuppressants can be used for eczema?

A

Tacrolimus

Pimecrolmus

23
Q

What systemic immunosuppressant can be used for eczema?

A

Azathioprine

24
Q

In photosensitive dermatitis what is the key clinical feature that indicates this diagnosis?

A

Collar cut off

25
Q

When does stasis dermatitis occur?

A

Secondary to oedema, RBC extravasation, hydrostatic pressure - Vascular disease

26
Q

What is the seborrhoeic dermatitis?

A

Cradle cap

27
Q

What is pampholyx dermatitis?

A

acute, vesicles on lateral aspect of finger

28
Q

What is eczema herpeticum?

A

monomorphic punched out lesions caused by herpes simplex

29
Q

What is lichen simplex?

A

Response to the skin being repeatedly scratched or rubbed over a long period of time

Dermatology (13 decks)

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