Derm lect 4 Flashcards
Acute dermatitis (Eczema) is what type of hypersensitivity reaction
Type 1: IgE mediated
- “the itch that rashes”
- characterized by pruritus and disruption of skin surface
- begins early in life with chronic exacerbations and remissions
atopic dermatitis
what is the atopid triad
- atopic dermatitis
- allergic rhinitis (hay fever)
- asthma
clinical presentation
- ranges from ill-defined, erythematous, scaling pathces to edematous papules and vesicles
- flexural surfaces, hand/foot in children and adults
dermatitis (eczema)
a form of eczema that is coin-shaped
nummular eczema
clinical presentation:
- cheeks, scalp and extensor surfaces common in infants
- clue: sparing of diaper area
atopic dermatitis
what are some common complications from dermatitis (ezcema)
- excoriation
- lichenification
- fissures
- secondary cellulitis
- eczema herpeticum- disseminated viral infection (HSV 1 or 2)
treatment for eczema
- avoid exposure to triggers (allergens, wool clothing); rubbing or scratching; excessive bathing; lotions
- use Emollients (vaseline)
- during exacerbation can briefly use topical steroid
this secondary skin condition is the result of excessive scratching or rubbing.
Clinical presentation:
- exaggerated skin markings, dry, leathery appearance, pigmentation
- common areas: back of neck, wrists, forearms, lower legs, genitals
lichen simplex chronicus
clinical presentation:
- deep seated vesicles that coalesce and rupture
- common areas: hands (80%), sides of fingers, palms and soles
- intensely pruritic
- episodes are usually weeks to months apart, spontaneous remission after 2-3 weeks
Dyshidrotic eczema
what precipitates dyshidrotic eczema
- emotional stress
- hot weather
- found in those with nickel allergy
treatment of dyshidrotic eczema
- wet dressing
- topical steroid
clinical presentation
- rough, raised papules (flesh, red, or brownish)
- forms horny plugs in hair follicles
- common area: outer upper arms, thighs, cheeks, upper back
- usually worse in winter months
- improves with age
keratosis pilaris: disorder of keratinization
What is allergic contact dermatitis? What are some examples of things that cause it?
- delayed-type hypersensitivity reaction
- poison ivy; nickel; latex
this type of rash is caused by repeated friction and mechanical irritation. Ex: household duties: hands in water, detergents, solvents
irritant contact dermatitis
treatment for contact dermatitis
- discontinue exposure to allergen or irritant
- wear gloves or protective clothing
- apply emollient
- apply topical steroid twice daily for several weeks prn
clinical presentation
- greasy scales and yellow-red coalescing macules, patches, and papules affecting scalp, face (eyebrows, eyelids), ears, presternal skin and upper back
Seborrheic dermatitis
what is the cause of seborrheic dermatitis
overproduction of sebum in associated with yeast: malessezia furfur (formly known as pityrosporum ovale)
clinical presentation:
- yellow, greasy adherent scale on vertex of scalp
- may affect diaper area and axillary skin
- seen in infants
cradle cap: form of seborrheic dermatitis
treatment of seborrheic dermatitis and cradle cap
- cradle cap: olive oil to loosen crusts
- selenium sulfide or anti-dandruff shampoo
- mild topical steroids
clinical presentation
- possible prodrome: malaise, pharyngitis
- exanthematous eruption with a primary plaque “Herald patch” usually on the trunk
- followed by secondary rash 1-2 weeks later: fine scaled, pink, oval lesions and plaques that are arranged in a christmas tree pattern
- may be very itchy, but in most cases no pruritus
pityriasis rosea
cause of pityriasis rosea
benign, viral skin eruption of unknown etiology
treatment for pityriasis rosea
- self-limiting rash
- oral antihistamines (e.g. claritin)
- medium strength topical steroid
- sun exposure helps
clinical presentation
- four “P’s”- purple, pruritic, polygonal, papules
- middle ages adults
- common areas: wrists, back, shins, scalp, penis and mouth (50%)
- wickham’s striae = white lines
Lichen Planus
