Flashcards in Eczema Deck (14):
What is the diagnostic criteria for eczema?
Itchy skin condition in last 12 months plus 3 of:
- onset 2yo
- history of flexural involvement
- history of generally dry skin
- history of other atopic disease or history in 1st degree relative in <4yo
What are the causes/risk factors of eczema?
Causes of acute flares?
- many genes implicated
- key role for Filaggrin gene
- atopic FH
Epidermal barrier dysfunction
- viral illness or period of poor health
- environmental triggers - heat, cold, allergens
- food allergies
What are the symptoms/signs of eczema?
Itch, redness, scaling, papules, vesicles
Flexural but can involve all body sites
Lichenification, plaques, fissuring
How is eczema investigated?
- applied monday
- remove wednesday
- re-assess friday
Most reactions at 96 hours
What are the different types of eczema?
- contact dermatitis (irritant, allergic)
- lichen simplex
- photoallergic, photoaggravated
- seborrheic dermatitis
- juvenile plantar dermatitis
What are the general different types of eczema treated?
Avoid causative/exacerbating factors
Intermittent topical steroids
What are different types of emollients?
Ointments - greasy but effective
Creams - lighter
Lotions - more watery
What different steroids are used?
Hydrocortisone (lower potency)
Betamethasone (higher potency)
What are the calcineurin inhibitors?
Topical pimecrolimus and tacrolimus
What different immunosuppressants are used?
When might you use anti-fungals in eczema and which anti-fungal?
Seborrheic keratoses - ketoconazole
- consider HIV test if severe
What is the pathology of eczema?
Spongiosis - intercellular oedema within the epiudermis
Acanthosis - thickening of epidermis
Inflammation - superficial perivascular lymphohistiocytic infiltrate
What are the histological features of acute dermatitis?
- intercellular oedema within the epidermis
- can lead to accumulation of intra-epidermal vesicles
- infiltration of the epidermis with lymphocytes is common
- dermal changes include varying degrees of oedema and a superficial perivascular infiltrate with lymphocytes, histiocytes and occasional neutrophils and oesinophils