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Flashcards in Dermatitis Deck (45)
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1

What do you give for allergic rash

Anti-histamine
Steroid
Query urticaria ??

2

Where is dermatitis and where does it tend to affect

Papules and vesicles on erythematous base
Flexures
Face and neck in baby

3

What can causes be

Endogenous
- Atopic = most common
Exogenous

4

What is pathology behind atopic dermatitis

Genetics - FH atopy
Enviornment
Epidermal barrier dysfunction due to fliggarin dysfunction that allows allergens and irritants to enter causing immune response and water to be lost

5

What genetics

Fligarrin gene
Fliggarin binds keratin and produces moisture
Atopic FH - asthma / hay fever / food allergy

6

What histology

Spongiosis (intracellular oedema) within epidermis
Acanthosis (thickening of epidermis)
Inflammation

7

What is classification of atopic

Itchy skin condition in last 2 months + 3 of
- Onset <2
- Flexural involvement
- Hx dry skin
- Hx atopy

8

What are clinical features

Itchy dry skin condition
Affects flexures
Face, eyelids + neck = common in infants
Antecubital and popliteal fossa
Can affect wrist, hands and ankles
Tend to spare nappy area

9

What are acute changes

Erythema
Dry scale patches
Papule
Vesicules
Weepy (Exudative)
Exudates, crusting and excoriation

10

What are chronic changes

Lithification - papular eruption due to scratching / thickening
Plaque
Fissures
Hypo and hyper pigmentation

11

What are nail changes

Ridging
Pitting
Paronychia
Onycholysis

12

What causes acute flares

Viral illness
Stress
Environment
Food allergy
Pet allergy
Teething

13

What are exogenous types of exzema

Allergic Contact = child sensitised
Irritant contact = repeat contact
Lichen simplex
Photoallergic

14

What causes contact dermatitis

Irritant or allergic
Type 4 hypersensitivity
APC takes allergic to LN and present to T cells

15

What are features

Can take 48-72 hours to develop
Erythema common
Crusting and vesicles are rare

16

How can you Dx

Skin patch set with potential allergen
IgE
Skin swab

17

How do you Rx

Potent steroid

18

What are other endogenous causes

Discoid
Venous / varicose
Seborrheic
Pomphoylx
Asteatotic Eczema herpeticum

19

What is discoid

Circular plaques of eczema
Can develop at trauma / irritation sites

20

What cause venous eczema

Increased venous pressure due to venous stasis
Lymph oedema
Varicose veins
Chronic swelling
RT in children

21

What helps

Emollient
Topical steroids
Compression stockings

22

What does seborrheic dermatitis tend to affect

Affects areas rich in sebaceous glands
Scalp / proximal flexures / face
Usually <6 months and clears without Rx
In adults associated with Malasseizia yeast

23

What are features

Erythematous, sharply marginated lesions
Dermatitis + dry crusted skin
Covered with greasy looking scales
In children causes cradle cap (dry, flaky, erythematous with coarse yellow scale)

24

What may develop in children

Otitis externa
Blepharitis

25

What is associated in adults

HIV - test if severe
Parkinsonism
- can improve with L-dopa

26

How do you Rx

Cradle cap
- Baby oil then brushing of or white petroleum jelly over night
- Topical anti-fungal if doesn't work

Scalp
- Anti-fungal shampoo
- Topical steroid if severe itch

Face and body
- Topical anti-fungal
- Topical steroid short term
- Recurrence common

27

What is pomphoylx eczema and what does it require

Very itch
Sudden onset crops of vesicles
Palms and soles
Can lead to desquamation
Requires intense steroid

28

What is asteatotic eczema

Very dry skin
Common with hot climate or excessive washing
Shins commonly involved

29

What causes eczema herpeticum

Disseminated viral infection - HSV or VZV on top of eczema
Common in children with atopic eczema where virus is able to enter skin

30

How does it present

Itchy clusters of blisters and erosions
Widespread painful vesicular rash
Fever
Lethargy
Irritable
NOT itchy
Swollen LN / lymphadenopathy