Derm I Flashcards
(107 cards)
Pruritis and erythema are typically located where in infants?
The face
The most common chief complaint of atopic dermatitis is?
pruritis
atopic dermatitis is associated with?
Asthma and/or exposure to allergens in pt hx
Atopic dermatitis description:
pruritic, chronic, relapsing
Most common location for atopic dermatitis?
flexor surfaces
Besides the most common location, where else is atopic dermatitis found?
face, trunk, hands, upper chest
atopic dermatitis lesions are characteristically?
erythematous, macular or papular, possible crusting, oozing, can develop lichenification with chronic scratching
diagnosis of atopic dermatitis?
no test is diagnostic. IgE may be elevated. eosinophils might be present
1st line treatment for atopic dermatitis:
frequent lubrication with thick emollient creams: infants-hydrocortisone, adults- triamcinolone
2nd line treatment for atopic dermatitis:
systemic steroids, plastic occlusive dressing with topicals, immunomodulators
contact dermatitis is?
a rxn to an external substance
two forms of contact dermatitis:
primary irritant dermatitis and allergic contact dermatitis
a pt w/ contact dermatitis will present with what hx?
pruritis with exposure to irritant
contact dermatitis PE will show?
acute: vesicles, macules, papules, and bullae with surrounding erythema. can also be erythematous with lichenification
tests for contact dermatitis?
patch test
tx for contact dermatitis?
avoid irritant, lotion w/ zinc oxide, talc, menthol, phenol (gold bond), higher potency topical steroid for short-term (fluocinonide), then transfer to med to low potency topical steroid (triamcinolone). hydroxizine or diphenhydramine for pruritis. systemic steroids in indicated. ABX if 2ndary bacterial infection
diaper dermatitis description:
occurs under the covered area of a diaper
a pt w/ diaper dermatitis will present with a hx of?
recent diarrhea or illness. irritation or agitation
diaper dermatitis PE:
mild= shiny erythema +/- scaling
moderate= papules, vesicles, erosions
prominent lesions on the buttocks, thighs, mons pubis, scrotum. skin folds are usually spared or affected last. satellite lesions.
diaper dermatitis with satellite lesions indicate an infection most likely caused by?
Candida
test for diaper dermatitis?
rarely needed if ever
tx for diaper dermatitis:
if purely contact dermatitis: low potency steroid (hydrocortisone)
if Candida is suspected: antifungal (miconazole)
nummular eczematous dermatitis is similar in sxs and tx to?
atopic dermatitis
specific tx for nummular eczematous dermatitis:
avoid excessive use of soap. but, use super-fatted soaps like dove. lubricate the skin immediately after bath or shower.