Derm - Eczema

Question 1

What are the major endogenous types of Eczema?

Answer 1

Atopic
Seborrhoeic
Discoid
Pompholyx
Varicose

Question 2

What could cause eczema in general to flare up?

Answer 2

• Infection
• Environment e.g. hot/cold
• Pets (if sensitized)
• Teething
• Stress
• Idiopathic

Question 3

In general how do you treat eczema?

Answer 3

• Topical Steroids
• Emollients
• Soap substitute

If topical steroids don’t help:

-steroid sparing agents: 
Protopic ointment, Elidel cream
- UVB Phototherapy
- Immunosuppresants- methotrexate
Biologics: Dupilumab

Question 4

What are the dangers of steroids?

Answer 4

Skin thinning if used for a prolonged time

Question 5

steroids available

Answer 5

Mild: Hydrocortisone.
Moderate: Eumovate
Potent: Betnovate
Very potent: Dermovate

Question 6

Risk factors for atopic dermatitis?

Answer 6

Another ATopic TRiad condition (asthma or hayfever)

FH of atopic conditions

Question 7

What causes seborrheic dermatitis?

Answer 7

Malassezia Yeast

Question 8

How does seborrheic appear?

Answer 8

On the scalp/face, mainly in <3month olds

Its ass with cradle cap

Question 9

How do we treat seborrheic dermatitis?

Answer 9

emollients
daktorcot ointment
Ptotopic ointment

+ Antifungal creams/shampoos

Question 10

Describe discoid eczema?

treatment?

Answer 10

Scattered annular/circular itchy patches

Separate to or part of atopic eczema

need potent topical steroid- Bentovate C ointment

Question 11

List some allergens causing Allergic Contact Dermatitis?

Answer 11

Milk
Soy
Peanuts
Eggs
Wheat
Dust Mite
Pet Dander
Pollen

Question 12

When would you suspect an allergy in eczema?

Answer 12

• Immediate reaction to food
• GI problems
• FTT
• Unresponsive to treatment
• Generalised itching
• Atopy

Question 13

How do we test for allergy?

Answer 13

Blood test for specific IgE

Skin Prick & PAtch testing

Question 14

How do you manage an allergy?

Answer 14

Dietary elimination for 8wks (refer to dietitian

Question 15

Eczma presentation?

Answer 15

red, dry, itchy skin eruption

flares and settles intermittently

Question 16

if get atopic eczema before 3 months what should you be thinking about?

Answer 16

CMPA (cows milk protein allergy)

Question 17

atopic eczema presentation

Answer 17

widespread diffuse scale erruption

VERY itchy

Question 18

what is eczema from?

Answer 18

barrier defect
water loss

Fillaggrin mutation

Question 19

How much is one FTU?

Answer 19

0.5g

Question 20

When to suspect Type 1 food allergy?

Answer 20

Immediate reaction (type 1 reaction)
lip swelling,
facial redness/itching]anaphylactic symptoms

Question 21

when to suspect type 2 food allergy?

Answer 21

worsening of eczema 24-48hours after injestion
GI proboems
failure to thrive
severe eczema unresponsibve to treatment
severe generalised itching- even if skin looks clear

Question 22

8 week old baby with severe widespread eczema
no response to hydrocortisone applied sparingly
strong FH of Atopy

treatment?

Answer 22

Eumovate daily for 5 days

Betnovate once daily for 7-10 days

Hydromol ointement all over

Hydromol bath and shower for bathing

consider CMPA and mum trial diary free diet

Question 23

How to use steroids

Answer 23

Should be used in finger tip units for:

• 1/day for 1-2wks
• Then if it improves continue using on alt days for a few days
• If stubborn areas you can use twice weekly for those areas

more sensitive areas- need to limit steroid use