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10. Dermatology > Eczema > Flashcards

Flashcards in Eczema Deck (20)
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1

What is eczema caused by? (3)

Genetics: filaggrin expression defects (chromosome 1)
Immune factors
Atopy

2

Describe the pathophysiology of eczema. (3)

1. Skin barrier defect

2. This causes increased skin permeability
a. This causes inflammation and oedema

3. This causes decreased antimicrobial function
a. This causes increased susceptibility to infection

3

List 7 types of eczema.

Which ones are endogenous, and which ones are exogenous?

ENDOGENOUS:
Atopic eczema
Seborrhoeic eczema
Discoid eczema
Varicose/gravitational/stasis eczema
Pompholyx eczema

EXOGENOUS:
Contact dermatitis
Photoreactions

4

Describe the clinical features of atopic eczema. (4)

Itchy, vesicular rash
Lichenification
Underlying erythema
Ulceration/exfoliation (due to scratching)

5

Describe the distribution of atopic eczema. (3)

Poorly defined areas
Face
Flexor surfaces

6

List 4 complications of atopic eczema. Give some examples where relevant.

Bacterial infection (e.g. staph. aureus)
Viral infection (e.g. molluscum contagiosum, viral warts, eczema herpeticum)
Growth retardation
Psychological impact

7

List 4 conditions associated with atopic eczema.

Asthma
Hay fever
Allergy
Conjuctivitis

8

What causes seborrhoeic eczema?

Describe the typical distribution. (4)

Pityrosporum ovale (yeast) infection

DISTRIBUTION:
Scalp
Eyelids
Nostrils
Lips

9

What is seborrhoeic eczema associated with? (2)

Malassezia yeasts
HIV

10

Describe the clinical features of discoid eczema. (1)

Describe the typical distribution. (1)

What is discoid eczema associated with? (1)

Round lesions

Mainly on limbs

Associated with: alcohol misuse

11

Describe the clinical features of varicose/gravitational/stasis eczema. (2)

Describe the typical distribution. (1)

Itchy, vesicular rash
Leg ulcers

Distribution: skin over large veins (esp. legs)

12

What is varicose eczema associated with? (2)

Peripheral vascular disease
Venous insufficiency

13

Describe the pathophysiology of varicose eczema. (3)

1. Underlying venous disease causes incompetence of deep perforating veins

2. This causes increased hydrostatic pressure, causing venodilation

3. Venodilation causes the overlying skin to be stretched
a. This causes eczema over affected veins
b. This may cause leg ulceration

14

Describe the clinical features of pompholyx eczema. (1)

What is the typical distribution? (1)

Itchy, vesicular rash

Distribution: palms/soles

15

Describe the pathophysiology of contact dermatitis. (1)

1. Type 4 (delayed) hypersensitivity reaction, mediated by mast cells

16

Give 5 examples of allergens which might cause contact dermatitis.

Nickel
Chromate (e.g. cement)
Cobalt
Colophony (e.g. glue, plasters)
Fragrance

17

What can cause photoreactions? (1)

Allergens
Drug reactions

18

How would you manage atopic eczema? (8)

TOPICAL THERAPIES:
Emollients
Topical steroids
Bandages (to stop scratching)

SYSTEMIC THERAPIES:
Sedative antihistamines
Antibiotics/antivirals (if secondary infection)

LIFESTYLE FACTORS:
Avoid exacerbating factors
Education for parents/children
Information about support (e.g. National Eczema Society)

19

How would you manage seborrhoeic eczema? (4)

Medicated anti-yeast shampoo (conatining ketoconazole, e.g. Nizoral)
Antimicrobial creams
Mild steroid creams
Moisturisers

20

How would you manage varicose eczema? (4)

Emollients
Mild-moderate topical steroids
Compression bandages/stockings
Surgical correction of venous disease