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?
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.