CD, Eczema, SD

Question 1

Types of Dermatitis

Answer 1

Atopic Dermatitis (Eczema)
Contact Dermatitis
Seborrheic Dermatitis
Photodermatitis

(Stasis dermatitis, multifactoral)

Question 2

Chronic inflammatory skin condition characterized by pruritis, erythematous and scaly lesions often localized to flexural surfaces and may be associated w/ personal/family hx of atopic disease (asthma, allergic rhinitis)

Answer 2

Atopic Dermatitis

Question 3

Genetic defect in ______ disrupting epidermis in Atopic dermatitis –> immune cells/antigens communicating

Answer 3

Filaggrin

Question 4

Hallmark: Itching, tx w/ topical glucocorticoids Rx

Answer 4

Atopic dermatitis

Question 5

Clinical features of atopic dermatitis

Answer 5

Pruritis
Facial/extensor papulovesicles in infancy
Flexural lichenification in adults and older children
Chronic-relapsing course
personal or family hx of atopic dz

Question 6

Differential Dx for AD

Answer 6

Congenital, chronic dermatoses, infection/infestation, malignancies, immunodeficiencies, metabolic disorders, immunologic disorders

Question 7

Tx for AD

Answer 7

Cutaneous hydration-emollients
Topical Glucocorticoids Rx
Identify and eliminate flare factors
Tx of pruritis (antihistamines, tar)

Second line -
protopic, topical immunomodulator inhibits Tcell activation
Eliden - calcineurin inhibitor

Question 8

Complications of AD

Answer 8

eye, infections, hand dermatitis, exfoliative dermatitis, impetigo, herpes inf, contact sensitization

Question 9

Prognosis for AD

Answer 9

spontaneous resolution after age 5 in 40%, 84% outgrow by adolescence

worse if more sxs of atopy

Question 10

Hallmark: Linear, some itching too

Answer 10

Contact Dermatitis

Question 11

Inflammatory reaction of skin precipitated by exogenous chemical

Answer 11

Contact dermatitis

Question 12

Two types of CD

Answer 12

Irritant - direct toxic effect

Allergic - immunologic rexn that causes tissue inflammation (Type IV hypersensitivity)

Question 13

Clinical features of acute vs. chronic

Answer 13

Acute - linear streaks of vesicles (poison ivy especially)

Chronic - lichenification, eczematous rexn

Question 14

Differential for CD

Answer 14

Atopic dermatitis, seborrheic dermatitis, stasis dermatitis, fungal infec, bacterial cellulitis

Question 15

Lab testing for CD

Answer 15

No testing for irritant

Patch testing for allergic CD

Question 16

CD tx

Answer 16

Prevention-Allergen avoidance
Symptomatic tx
physiochemical barriers
tolerance induction

Question 17

Chronic, superficial inflammatory process affecting hairy regions of body (scalp, eyebrows and face especially)

Answer 17

Seborrheic dermatitis

Question 18

One of the most common skin manifestations in patients with HIV, paralysis/quadriplegia, parkinsons

Answer 18

Seborrheic dermatitis

Question 19

Two peaks of SD

Answer 19

Infancy in first 3 mo, adult 40-70

Question 20

Clinical Features of SD

Answer 20

Bilateral, symmetrical
Predilection for hairy regions
Patches and plaques w/ indistinct margins
Dandruff
Uncommon to have hair loss

Question 21

Differential Dx of SD

Answer 21

Atopic dermatitis, psoriasis, tinea capitis, SLE, rosacea, histiocytosis X

Question 22

Drugs causing SD rash

Answer 22

Arsenic, gold, methyldopa, cimetidine, neuroleptics

Question 23

Physical factors for SD

Answer 23

Seasonal variation (worse in autumn, winter) 
Those who get PUVA for psoriasis at risk (mask face)

Question 24

Tx goals for SD

Answer 24

Loosening and removal of scales and crusts
Inhibition of yeast colonization
Control of secondary inf
Reduction of erythema and itching
Control rathe than cure

Question 25

Tx of SD for infants (cradle cap)

Answer 25

Removal of crusts with 3-5% salicylic acid in olive oil or water soluble base Warm olive oil compresses low potency glucocorticoids mild baby shampoos Drying lotions in skin folds, tx for candidiasis

Question 26

Tx of SD for adults

Answer 26

Anti-inflammatory, antifungal, kerolytics daily shampoo w/ special ingredients crusts - can remove overnight w/ topical glucocorticoids or salicylic acid in water soluble base Tinctures/alcohol AGGRAVATE Antifungals (imidazoles, metronidazole)

Question 27

Immune based dermatitis in which UV light alters antigen to make it an effective immunogen resulting in typer IV cell mediated reactions

Answer 27

Photodermatitis

Question 28

Commonly seen with _____ and _______ - Photodermatitis

Answer 28

thiazide diuretics and tetracyclines

Question 29

Tx photodermatitis

Answer 29

stop med, UVA/UVB blocker sunscreen