Eczema

Question 1

Eczema (dermatitis) refers to a variety of skin conditions characterised by epidermal ______________ and ______________

Answer 1

inflammation

itching

Question 2

What are the main types of eczema? (5)

Answer 2

1. Irritant
2. Allergic contact
3. Atopic
4. Venous
5. Discoid

Question 3

________________, due to scratching and rubbing, often presents in chronic eczema.

Answer 3

Lichenification

Question 4

Lichenification, due to scratching and rubbing, often presents in _______________.

Answer 4

chronic eczema

Question 5

____________ eczema is one of the most common types and it usually involves itchy, red, dry skin which can become infected and lichenified

Answer 5

Atopic

Question 6

Atopic eczema is one of the most common types and it usually involves itchy, red, dry skin which can become ____________ and ____________

Answer 6

infected

lichenified

Question 7

Management of eczema involves the removal or treatment of contributory factors including ______________ and ______________ irritants

Answer 7

occupational

domestic

Question 8

Frequent and liberal use of ______________ is advised for dry skin and itching associated with eczema

Answer 8

emollients

Question 9

Emollients increase the efficacy of ______________ and have a steroid sparing action

Answer 9

topical corticosteroids

Question 10

The use of _______________ should continue even if the eczema improves or if other treatment is being used

Answer 10

emollients

Question 11

The use of emollients should ________________ if the eczema improves or if other treatment is being used

Answer 11

continue even

Question 12

Aqueous cream is generally not recommended due to the high risk of developing _______________

Answer 12

skin reactions

Question 13

In addition to emollients, __________________ are also often required in the management of eczema

Answer 13

Topical corticosteroids

Question 14

For eczema on the face, genitals, or axillae, consider a ___________ potency topical corticosteroid

Answer 14

mild

*and only increase to a moderate potency topical corticosteroid if necessary

Question 15

______________ (strength) topical corticosteroids are generally required for use in adults with moderate or severe eczema on the scalp, limbs, and trunk

Answer 15

Moderate to potent

Question 16

In patients with frequent flares, a ____________ can be applied to prevent further flares using various regimens (e.g. on 2 consecutive days each week)

Answer 16

topical corticosteroid

Question 17

Under the care of a specialist, _________________ are sometimes applied over topical corticosteroids or emollients to treat eczema of the limbs

Answer 17

bandages (including those containing ichthammol with zinc oxide)

Question 18

______________ dressings can be used to provide a physical barrier to help prevent scratching and improve retention of emollients

Answer 18

Dry-wrap

Question 19

Topical _____________ is licensed for the treatment of mild to moderate atopic eczema. _____________ is licensed for topical use in the treatment of moderate to severe atopic eczema

Answer 19

pimecrolimus

Tacrolimus

• Both are calcineurin inhibitors and should be considered as a second-line treatment option only, unless there is a specific reason to avoid or reduce the use of topical corticosteroids

Question 20

Are antihistamines recommended for routine use in the management of atopic eczema?

Answer 20

Not for routine use; However, if there is severe itching or urticaria, consider a non-sedating antihistamine. A sedating antihistamine can be considered if itching causes sleep disturbance

Question 21

If there is severe itching or urticaria associated with atopic eczema, consider a _______________. A sedating antihistamine can be considered if itching causes sleep disturbance

Answer 21

non-sedating antihistamine

Question 22

However, if there is severe itching or urticaria, consider a non-sedating antihistamine. A ________________ can be considered if itching causes sleep disturbance

Answer 22

sedating antihistamine

Question 23

Breaks in the skin caused by eczema are susceptible to ___________________

Answer 23

bacterial infection (commonly with Staphylococcus aureus and occasionally with Streptococcus pyogenes) and may require treatment with a topical or systemic antibacterial

Question 24

Breaks in the skin caused by eczema are susceptible to bacterial infection (commonly with ________________ and occasionally with ________________) and may require treatment with a topical or systemic antibacterial

Answer 24

Staphylococcus aureus

Streptococcus pyogenes

Question 25

Episodes of infected eczema usually co-exist with a flare and will require management with treatments such as _________________ and ________________

Answer 25

emollients topical corticosteroids

Question 26

Eczema can also be infected with _______________ virus

Answer 26

herpes simplex *Immediate referral to secondary care is required in patients presenting with suspected eczema herpeticum

Question 27

What is eczema herpeticum?

Answer 27

Eczema infected with herpes simplex virus

Question 28

What is the drug management of severe refractory eczema?

Answer 28

Systemic drugs acting on the immune system eg cyclosporin, azathioprine (unlicensed), mycophenolate (unlicensed), phototherapy

Question 29

Which drugs are used in the treatment of moderate to sever atopic eczema? (2)

Answer 29

Dupilumab Baricitinib

Question 30

____________ is licensed for the treatment of severe chronic hand eczema refractory to potent topical corticosteroids

Answer 30

Alitretinoin

Question 31

patients with ______________ features of eczema are more likely to respond to alitretinoin than those with pompholyx

Answer 31

hyperkeratotic

Question 32

What is pompholyx?

Answer 32

Also known as dyshidrotic eczema, a type of eczema where tiny blisters develop across the fingers, palms and hands and sometimes the soles of the feet

Question 33

Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the yeast ______________ and affects the scalp, paranasal areas, and eyebrows

Answer 33

Malassezia

Question 34

Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the ____________ Malassezia and affects the scalp, paranasal areas, and eyebrows

Answer 34

yeast

Question 35

Seborrhoeic dermatitis (seborrhoeic eczema) is associated with species of the yeast Malassezia and affects the ______________, ____________ areas, and ______________

Answer 35

scalp paranasal eyebrows

Question 36

Shampoos active against Malassezia (including those containing _______________ or _____________) and combinations of mild topical corticosteroids with suitable antimicrobials are used

Answer 36

ketoconazole coal tar