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Flashcards in Eczema Deck (13):

What is atopic eczema?

Inflammatory skin disease (dermatitis)

Starts in early infancy in >80%, often on the face and extensor surfaces.
- Later the typical flexural pattern develops


What is the atopic march?

- Eczema beginning in infancy
- Asthma usually after 2 years of age
- Hay fever from 7yrs


What is the clinical picture of seborrhoea can eczema of the newborn?

- Cradle cap
- Flexural eczema
- Napkin eczema

- Often not itchy, may develop into typical atopic eczema
- May develop into psoriasis later


What is the UK Working Party’s criteria for diagnosis of atopic dermatitis?

Itching plus 3 or more of:

- Visible flexural rash
- History of flexural rash (cheeks and extensor in infants)
- Personal history of atopy
- Dry skin in past year
- Onset before 2 years of age.


Genetic factors involved in atopic eczema?

- Genes involving skin barrier function.
- Over production of inflammatory cytokines.
- Increased IgE production.

- The cornfield cell envelope (CCE) is the main outer cutaneous barrier. It prevents water loss and prevents entry of infections agents. Impaired CCE barrier function is a major cause of atopic eczema.


What protein mutations predisposes to ichthosis vulgar is and atopy?


Filaggriun is a protein present in keratohyalin granules in the granular layer of the epidermis, it helps in terminal differentiation of cells.


What type of hypersensitivity reaction is eczema?

Eczema is a delayed type IV +/- type 1 reaction.


What are the 3 modes of actions of topical corticosteroids?

- Anti-inflammatory
- Vasoconstrictive
- Antiproliferative


How much is one fingertip unit?

Half a gram. (Covers 2 hand areas)


What type of medication is Tacrolimus?

It is a calcineurin inhibitor


Eczema treatment ladder:

1) Emollients alone

2) Emollients + mild topical corticosteroid (TCS)

3) Emollients + moderate TCS + possible calcineurin inhibitor

4) Emollients + potent/very potent TCS (short term + specialist help)


What is the role of antihistamines in atopic eczema?

Contra-indicated under 6 months old.

- Use sedating AH at night to help sleep.
- Non-sedating AH for day or school age.

No good evidence of efficacy but worth a trial if sleep disturbance or severe itching.


Eczema herpeticum clinical presentation and management?

- Emergency, needs same day referral.
- Immediate oral or systemic aciclovir.

- Monomorphic rash.
- Circular blisters or crusted erosions.
- May be umbilicated.