Dermatitis & Eczema

Question 1

What is Parakeratosis?

Answer 1

Skin cells turnover quickly, nuclei not removed from keratin layer

Question 2

What is Acanthosis?

Answer 2

Increased thickness of the epidermis

Question 3

What is Hyperkeratosis?

Answer 3

Increased thickness of keratin layer

Question 4

What is Papillomatosis?

Answer 4

Irregular epithelial thickening

Question 5

What is Spongiosis?

Answer 5

Intracellular oedema between keratinocytes. Water that has leaked out of the cells

Question 6

What is the classic rash presentation for eczema?

Answer 6

Itchy, ill-defined, eythemtous and scaly

Question 7

What is the most common type of dermatitis?

Answer 7

Contact allergic dermatitis

Question 8

What immunological cell causes the reaction of contact allergic dermatitis?

Answer 8

Langerhans cells

Question 9

What is the difference between contact allergic dermatitis and irritant contact dermatitis?

and what test should you do to differentiate?

Answer 9

Allergic is hypersensitivity 1 => IgE mediated
Irritant is a non-specific physical irritation

Skin allergen test

Question 10

What is Naptkin Dermatitis

Answer 10

Nappy rash - an allergic reaction to urine and faeces
NOTE
that is spares the flexures

Question 11

What other atopic disease is associated with eczema?

Answer 11

asthma
allergic rhinitis
food allergy
hayfever

Question 12

Where are common places to be affected by eczema?

Answer 12

Flexures –> knee, elbow, wrists
Eyes
Neck
Genital area

Question 13

What are the chronic changes of eczema?

Answer 13

Lichenification
Excoriation
Secondary infection

Question 14

What does crusting of eczema indicate?

Answer 14

Secondary infection –> s. aureus

Question 15

What virus causes Eczema Herpeticum?

Answer 15

Herpes simplex virus

Question 16

What infection gives the signature monomorphic punched out lesions?

Answer 16

Eczema Herpeticum

Question 17

What is the criteria in the UK for diagnosing atopic eczema?

Answer 17

Itching plus 3 or more:
visible flexure rash
history of flexure rash
personal history of atopy (or first degree relative if

Question 18

What are the treatments for atopic eczema?

Answer 18

Emollients 
Avoid irritants including showers gels and soaps 
Topical steroids 
Treat infection 
Phototherapy - mainly UVB
Systemic immunosuppressants 
(Biological agents)

Question 19

What is the most important gene to consider in atopic eczema?

Answer 19

Filaggrin

Question 20

What is discoid eczema?

Answer 20

Eczema in the form of a disc shaped rash

Question 21

What is photosensitive eczema?

Answer 21

Also known as CHRONIC ACTINIC DERMATITIS
Sun cause eczema rash
Will have sharp cut off where clothing covers the skin

Question 22

A patient comes in the suspected photosensitive eczema, but their rash does not have a cut off point despite being covered in clothing, what could the other diagnosis be?

Answer 22

Photosensitivity secondary to photosensitising drugs

Question 23

What causes stasis eczema?

Answer 23

Occurring due to physical trauma of increased hydrostatic eczema

Question 24

How is stasis eczema treated?

Answer 24

Bandaging or surgical intervention. Need to treat underlying cause

Question 25

What is stasis eczema secondary to?

Answer 25

Hydrostatic pressure Oedema Red cell extravasation

Question 26

What is Seborrhaoeic Dermatitis and who does it occur in?

Answer 26

Cradle cap and it occurs in young children and infants due to excessive production of sebum

Question 27

Treatment for Sebrrhaoeic Dermatitis?

Answer 27

Will clear on it own. Wash babies head, massage in oils etc.

Question 28

What is Pompholyx eczema?

Answer 28

Pompholyx is a type of eczema that causes tiny blisters to develop across the fingers, palms of the hands and sometimes the soles of the feet. It's also known as dyshidrotic eczema. Any acute eczema can cause ponphlolyx

Question 29

Where does lichen planus commonly present?

Answer 29

arms, legs and trunk mouth (oral lichen planus) nails and scalp vulva, vagina and penis

Question 30

Where are melanocytes found?

Answer 30

Dermo-epidermal junction

Question 31

What is the dermis composed of?

Answer 31

type I and type II collagen and formed by elastic fibres --> basically connective tissue

Question 32

What are the 4 reaction patterns in the classification of inflammatory skin disease?

Answer 32

i) Spongiotic -intraepidermal oedema ii) Psoriasiform-elongation of the rete edges iii) Lichenoid-basal layer damage iv) Vesiculobullous-blistering

Question 33

Example of Spongiotic -intraepidermal oedema?

Answer 33

Eczema

Question 34

Example of Psoriasiform-elongation of the rete edges?

Answer 34

Psoriasis

Question 35

Example of Lichenoid-basal layer damage?

Answer 35

Lichen planus | Lupus Erythematosus

Question 36

Example of Vesiculobullous-blistering ?

Answer 36

Pemphigoid Pemphigus Dermatitis Herpetiformis

Question 37

In what two pathologies of the skin would you see Neutrophils in the corneal layer?

Answer 37

Fungal infections | Psoriasis