Eczema Flashcards Preview

Dermatology > Eczema > Flashcards

Flashcards in Eczema Deck (12):
1

Eczema history

onset, pattern and severity

response to previous and current treatments

possible trigger factors

impact of condition on child and parent

dietary history

growth and development

personal and FH of atopic disease

effect on sleep and psychosocial wellbeing

itch

2

Diagnosis of eczema

when child has itchy skin and 3 or more of the following:

  • visible flexural dermatitis involving skin creases e.g. bend of elbows or behind knees (cheeks and or extensor areas if 18 months or under)
  • PH of flexural dermatitis (or dermaitis on the cheeks and/or extensor areas if 18 months or under)
  • PH of asthma or allergic rhinits (first degree relative if <4)
  • onset of signs andsymptoms under the age of 2 (dont use this criteria in children under 4)

3

assessment tools used in eczema

visual analgoue scales (0-10) capturing child an or parents assessment of severity, itch and sleep loss over previous 3 days and nights 

or 

POEM

CDLQI

IDQoL

DFI

4

Explaining Eczema to a parent

  • often improves with time
  • no all children grow out of it, may get worse in teenage or adult lif
  • often develop astham and or hayfever
  • sometimes food allergy can be associated with atopic eczema, particularly in young children
  • not clear what role factors such as stress, humidity or extremes of temperature have in causing flares - avoid where possible
  • may make skin darker or lighter temporarily 
  • saftey net for infection - weeping, pustules, crusts, fever, malaise

5

Description of eczema

characterised by papules and vesicles on an erythematous base 

6

presentation of eczema

itchy, erythematous dry scaly patches

common in flexor aspects - but extensor and face in infants

chronic scartching/ rubbing can lead to excoriations and lichenification 

7

Types of eczema

Endogenous:

  • discoid
  • varicose
  • atopic
  • seborrheic 

exogenous:

  • photodermatitis
  • contact allergic dermatitis
  • contact irritant dermatitis 

8

features of eczema

xerotic (Dry) skin

golden crusting - suspcious of secondary infection 

lihenification

 

9

Managment for infected eczema 

  • swabs from infected lesions
  • if localised clinical infection - topical AB with topical corticosteroids
  • wide spread - systemic AB 
  • fluclozacillin (Erythromycin if allergy) first line for S.aureus or streptococcal

10

Eczema Heprecticum - when to suspect and complications

dermatological emergency

usually close contact with someone with a cold sore 

suspect if:

  • rapidly worsening painful eczema
  • fever
  • grouped vesicles
  • eroded, punched out lesions

complications:

  • encephalitis
  • pneuominits
  • hepaitis 

11

Managment of eczema

emolliants - bath additives, creams, ointments 

topical corticosteroids 

  • mild potency for mild eczema
  • moderate potency for moderate eczema
  • potent for severe
  • dont use potent preperations in children without specalist dermatological advice 
  • facial eczema in a child: 1% hydrocortisone

phototherapy

systemic steroids, azathioprine, ciclosporin 

12

causes of erythrodermic eczema

withdrawal of systemic steroids

secondary infection with bacteria or virus

psychological stress

development of contact dermatitis