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Ambulatory Care Skills I > Contact Dermatitis Exam 3 > Flashcards

Contact Dermatitis Exam 3 Flashcards

(76 cards)

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1
Q

Characterized by inflammation, redness, burning, itching, and pustule formation on skin

A

Contact Dermatitis

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2
Q

2 Types of Contact Dermatitis

A

Irritant Contact Dermatitis (ICD)

Allergic Contact Dermatitis (ACD)

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3
Q

Inflammatory reaction due to exposure to irritant substances

A

Irritant Contact Dermatitis (ICD)

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4
Q

Immunologic reaction caused by exposure to an antigen

A

Allergic Contact Dermatitis (ACD)

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5
Q

Mechanisms of ICD`

A

Disruption of skin barrier
Changes in cells of epidermis
Release of pro-inflammatory cytokines

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6
Q

Most commonly affected areas are __________ (often due to exposure)

A

Hands and face

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7
Q

______ % of cases have hand involvement

A

80%

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8
Q

Existing skin conditions ____________ can result in worse cases of ICD

A

Atopic Dermatitis

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9
Q

Can effect individuals of any age

Infants and elderly more at risk due to ________

A

thinner epidermal layers

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10
Q

________ can play a role in type of exposure

A

occupation

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11
Q

Substances associated with ICD

A 
Strong acids (hydrochloric, sulfuric)
Strong bases (sodium, potassium)
Detergents, soaps
Fiberglass
Oils
Urine/feces
Wood dust
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12
Q

Clinical Presentation of ICD

A 
Inflammation and swelling
Itching and burning
Rash 
Hyper/hypo-pigmentation
Scaling of skin, dryness
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13
Q

Goals of Therapy ICD

A

Remove the offending agent
Relieve inflammation and irritation
Educate patient on prevention and treatment

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14
Q

Non-Pharmacologic Therapy for ICD

A

Flush area with tepid water and mild soap

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15
Q

Non-Pharmacologic Prevention for ICD

A

Wear protective clothing

Use of emollients and barrier creams

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16
Q

Pharmacologic Treatment Options

A

Emollients
Colloidal Oatmeal Baths
Topical Corticosteroids

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17
Q

Immunologic reaction caused by allergen-specific T lymphocytes

A

Allergic Contact Dermatitis (ACD)

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18
Q

T cells migrate to site of contact and release inflammatory mediators

A

Allergic Contact Dermatitis (ACD)

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19
Q

ACD requires ________

A

sensitization

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20
Q

Induction Phase of ACD

A

Immune system sensitized by first exposure to antigen

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21
Q

Elicitation Phase of ACD

A

Cell-mediated, type IV delayed hypersensitivity reaction

Rash and symptoms typically appear within 24-48 hours, can take days

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22
Q

Epidemiology of ACD is frequency based on exposure such as

A

Occupation
Hobbies/Habits
Regional allergens

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23
Q

Epidemiology of ACD affects all ages, races and sexes and usually start to see around ______ years old

A

2-3 years old

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24
Q

Clinical Presentation of ACD

A

Localized to site of skin contact with allergen

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25
Symptoms may not appear for hours to days
delayed hypersensitivity with ACD
26
Symptoms of ACD
``` Severe itching Rash (skin red, swollen, and hot) Excessively dry skin Fluid-filled blisters Oozing blister that leave crust or scales ```
27
Substances Associated with ACD
``` Poison Ivy, Oak, Sumac Metal (Nickel) Lanolin Latex Neomycin Rubber Fragrances Adhesives ```
28
Among most common causes of ACD
Poison Ivy, Oak, Sumac
29
Dermatitis reaction is caused by exposure to
urushiol
30
urushiol can only be released through damage to the
plant
31
For Poison Ivy, Oak, & Sumac All members of the Toxicodendron genus. Exist mostly as
shrubs and vines
32
Important to wash hands after potential exposure to poison ivy, oak & sumac to prevent transfer to other body sites such as
eyes lips genitalia
33
Urushiol Induced Dermatitis has a highly variable presentation based
on patient sensitivity and extent of exposure
34
Urushiol can form
papules, plaques, or fluid-filled vesicles
35
______ cannot cause further transfer of dermatitis
Vesicular fluid
36
Complications of ACD include
secondary infections
37
For ACD scratching can further damage the dermal layer, creating ________-
open lesions
38
Lesions can then become infected with microbes from the skin like
Staphylococcus aureus Group A Streptococcus Escherichia coli
39
Goals of Therapy for ACD
Remove offending agent Treat inflammation Relieve itching that may lead to open lesions Relieve accumulation of debris from oozing and crusting
40
Exclusions for Self-Treatment for ACD
< 2 years old > 20% Body Surface Area (BSA) Dermatitis present > 2 weeks Presence of numerous bullae Discomfort in genitalia from itching, redness, swelling, or irritation involvement of or itching mucous membranes failure of self treatment after 7 days low tolerance for pain, itching, or discomfort
41
What formula is used for BSA
Mosteller Formula
42
Non-Pharmacologic Treatment for ACD
Cold or tepid shower to help reduce itching
43
Non-Pharmacologic Prevention for ACD
Avoid offending agent | Protective clothing
44
Pharmacologic Treatment for ACD
``` Topical Corticosteroid (Hydrocortisone 1% cream) Astringent compress Calamine products Colloidal oatmeal products Oral antihistamines ```
45
Avoid using what for Pharmacologic Treatment for ACD
topical antihistamines topical anesthetics topical antibiotics
46
Prevention of Poison Ivy, Oak, Sumac
Learn to identify Toxicodendron plants. Eradicate them from your residence. Use protective clothing and wash separately immediately after exposure Use barrier products
47
FDA approved protection against poison ivy/oak/sumac
Active Ingredient: Bentoquatum | IvyBlock Lotion
48
Ivy Black Lotion application
Apply before 15 minutes before exposure and reapply every 4 hours.
49
Contact Dermatitis in Pediatrics
similar to adults -- pay attention to package
50
Contact Dermatitis in Pregnancy
Short term use of topical agents generally considered safe
51
Contact Dermatitis in Geriatrics
Avoid first generation antihistamines
52
Follow up for ICD & ACD in
After 5 to 7 days of treatment
53
Complete resolution for ICD & ACD may take up to
3 weeks
54
When do contact provider for ICD & ACD?
``` Rash increase in size Symptoms worse Doesn't begin to improve within 7 days Spreads to or involves other genitals Covers extensive areas of the face or causes swelling of the eyelids ```
55
Itching begins when for ICD?
later
56
Itching begins when for ACD?
early
57
Stinging/Burning begins when for ICD?
early
58
Stinging/Burning begins when for ACD?
late or not at all
59
Does Vesicles, Bullae, Papules present in ICD?
rarely
60
Does Vesicles, Bullae, Papules present in ACD?
yes
61
What is the time to rash after exposure for ICD?
minutes to hours
62
What is the time to rash after exposure for ACD?
hours to days
63
Appearance of symptoms in relation to exposure for ICD
initial or repetitive exposure
64
Appearance of symptoms in relation to exposure for ACD
delayed
65
Causative Substances for ICD
Water, urine, flour, detergent, hand sanitizer, soap, alkalis, acids, solvents, salts, oxidizer, surfactants
66
Causative Substances for ACD
Toxicodendron plants, fragrances, nickel, latex, benzocaine, neomycin, leather
67
Substance concentration at exposure important for ICD?
Yes, Important
68
Substance concentration at exposure important for ACD?
Less important
69
Mechanism of reaction of ICD
Direct tissue damage
70
Mechanism of reaction of ACD
Immunologic reaction
71
Common Location of ICD
Hand, wrists, forearms, diaper area
72
Common Location of ACD
Anywhere that comes in contact with antigen
73
Presentation of ICD
No clear margins
74
Presentation of ACD
Clear margins based on offending agents
75
Who can be affected with ICD?
anyone
76
Who can be affected with ACD?
patients with allergy

Ambulatory Care Skills I (32 decks)

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