Dermatology Flashcards by Hannah Falconer

What is eczema?

Itchy, dry inflammatory skin disease

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What is the commonest type of eczema, particular in children?

Atopic eczema

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What is atopy?

Overactive immune response to environmental stimuli

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What is an atopic march?

Tendency to have:
Eczema
Asthma
Hayfever

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What is the distribution of atopic eczema in infancy?

Face/neck (cheeks)

Can spread more generally

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What is the distribution of atopic eczema in older children?

Flexural pattern

antecubital fosse, popliteal fosse, wrists, hands, ankles

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Where is the abnormality in atopic eczema?

Filaggrin expression

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What do filaggrin proteins do?

Bind the keratin filaments together, also play role in natural moisturising factor

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Due to the loss of skin barrier function in atopic eczema, what happens?

Loss of water
Irritants may penetrate
Allergens may penetrate

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What can childhood eczema flares be associated with?

Infection/viral illness
Environment: central heating/cold air
Pets
Teething
Stress
Sometimes no flare

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Where does seborrheoic dermatitis normally effect?

Scalp and face

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Which age group does seborrheoic dermatitis usually affect?

<3mo

Usually resolved by 12mo

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What is seborrheoic dermatitis associated with?

Proliferation of various species of the skin commensal Malassezia in its yeast form

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Which fungi is seborrheoic dermatitis associated with?

Malassezia

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What is an associated sign of seborrheoic dermatitis in infants?

Cradle cap

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What is the treatment for seborrheoic dermatitis?

Emollients, anti fungal creams/shampoos, mild topical steroids

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What is the pattern discoid eczema?

Scattered annular/circular patches of itchy eczema

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What can discoid eczema present as part of?

Atopic eczema

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Where does pomphylx eczema present?

Hand and foot

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What is pomphylz eczema characterised by?

Vesicles and intensely itchy

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What is exogenous eczema?

Allergic eczema - sensitised to allergen

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What type of hypersensitivity is associated with exogenous eczema?

Type IV hypersensitivity

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What is irritant eczema associated with?

Repeated contact:
water/soaps
Irritant foods: citrus, tomatoes, chemical irritants

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What type of reaction is an immediate reaction to food?

Type 1 reaction

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What happens during an immediate reaction to food?

Lip swelling Facial redness/itching Anaphylactoid symptoms

What type of reaction is a late reaction to food?

Type IV hypersensitivity

What happens during a late reaction to food?

Worsening of eczema 24/48hrs after ingestion GI problems Failure to thrive Severe eczema unresponsive to treatment Severe generalised itching - even when skin clear

What are the tests to do for an immediate reaction to food?

Blood test for specific IgE antibodies | Skin prick testing

What are the commonest food allergies?

Milk, soy, peanuts, eggs

What are common airbourne allergens?

House dute mites, pet dander, pollens

What are the tests for late reaction to food?

No test Dietary restrictions/eliminations 6-8wks Eliminate one food at a time

What is the treatment for eczema?

``` Emollients Topical steroids Calcineurin inhibitors UVB light therapy Immunosuppressive medication ```

What can happen with prolonged use of topical steroids?

Skin thinning

What is a mild topical steroid?

Hydrocortisone

What is a moderate topical steroid?

Eumovate

What is a potent topical steroid?

Betnovate

What is a very potent topical steroid?

Dermovate

How to use steroids for eczema?

Once daily 1-2wks

What is the unit for using topical steroids?

Finger tip unit

What is impetigo?

Common acute superficial bacteria skin infection

What are the features of impetigo?

Pustules | Honey-coloured crusted erosions

What is the causative bacteria of impetigo?

Staph aureus

What are the treatments for impetigo?

``` Topical antibacterial (fucidin) Oral antibiotic (flucloxacillin) ```

What does molluscum contagiosum look like?

Pearly papules, umbilicated centre

How long can molluscum contagiosum take to clear?

24 months | Is self-limiting

What is the incubation time for molluscum contagiosum?

2wk-6mo

What treatment can be used for molluscum contagiosum?

5% potassium hydroxide

What are viral warts?

Non-cancerous growths of the skin caused by infection with HPV

What are treatments for viral warts?

Topical - salicylic acid and paring | Cryotherapy

What are viral exanthems?

Viral exanthem is an eruptive skin rash that is often related to a viral infection

What are common symptoms with viral exanthems?

Fever, malaise, headache

What are examples of viral exanthems?

``` Chicken pox Measles Rubella Roseola Erythema infectiosum ```

What virus causes chickenpox?

Varicella-zoster virus

Who is susceptible to chickenpox at all times?

Immunocompromised

What does chickenpox present like?

Red papules Progressing to vesicles often start on the trunk Itchy Associated viral symptoms

What is the incubation period for chicken pox?

10-21 days

When is chickenpox contagious?

1-2 days before rash appears and until lesions have crusted

What is the common name for parvovirus?

Slapped cheek

What is the incubation for parvovirus?

7-10days

What are the symptoms of parvovirus?

Viral symptoms Erythematous rash cheeks Lace-like network rash (trunk and limbs)

What does parvovirus target?

Red cells in bone marrow

What is a rare complication of parvovirus?

Aplastic crisis

What virus causes hand, foot and mouth?

Enterovirus | Usually Coxsackie virus A16

What are the signs/symptoms of hand, foot and mouth?

Blisters on hands, feet and in mouth | Viral symptoms

What is the treatment for hand, foot and mouth?

Self-limiting | Supportive

What does eczema coxsackium appear like?

Flared sites picks out areas of eczema | Associated viral symptoms

What does eczema herpeticum appear like?

Unwell child Monomorphic punched out lesions Hx eczema

What is the treatment for eczema herpeticum?

Aciclovir

What are the signs/symptoms of orofacial granulomatosis?

Lip swelling and fissuring | Oral mucosal lesions

Which disease is susceptible to orofacial granulomatosis?

Crohn’s disease

What investigations for orofacial granulomatosis if GI symptoms?

Faecal calprotectin

What are clinical features of erythema nodosum?

Painful, erythematous subcutaneous nodules | Over shins

What are causes of erythema nodosum?

``` Infection IBD Sarcoidosis Drugs Mycobacterial infections Idiopathic ```

What is a rare disease linked to coeliac disease?

Dermatitis herpetiformis

How does dermatitis herpetiformis present?

Itchy blisters in clusters Often symmetry Scalp, shoulders, buttocks, elbows, knees

What are some causes of urticaria?

``` Viral infection Bacterial infection Food/drug allergy NSAIDs, opiates Vaccinations ```

What is urticaria?

Wheals/hives

What are treatment options for urticaria?

Antihistamines | Medication withdrawal

Dermatology Flashcards

(78 cards)