Eczema Flashcards
(17 cards)
What is another name for eczema?
Atopic dermatitis
What is eczema?
Irritated skin with barrier dysfunction and inflammation. Commonly affects the flexural surfaces
How is eczema defined? (need to have…)
An itchy skin condition in the last 12 months
Plus 3 of the following: Onset before age 2 History of flexural involvement History of generally dry skin History of other atopic disease History in 1st degree relative if under 4 yrs
What are the causes of eczema?
Mutation of the filaggrin gene Environmental factors Genetics Atopic family history Immune system dysregulation
What is seen in the histology of eczema?
Spongiosis (intercellular oedema) within the epidermis.
Acanthosis (thickening of the epidermis).
Inflammation - Superficial perivascular lymphohistiocytic infiltrate.
What are the clinical features of eczema?
Itch Distribution Flexures, Neck, Eyelids, Face, Hands and feet Tends to spare nappy area Acute changes Pruritus, Erythema, Scale, Papules, Vesicles Exudate, crusting, excoriation Chronic changes Lichenification, Plaques, Fissuring
What type of reaction is allergic eczema?
Type 4 hypersensitivity reaction
What kind of things damage the skin in irritant contact dermatitis?
Can get microtrauma from friction.
Cold, excess water or chemicals
How are irritants identified in eczema?
Patch testing-apply possible irritants methodically and remove two days later then assess two days after that. Skin will show inflammation at the section where the causative irritant is.
What is seborrheic dermatitis?
Distinctive pattern
Predilection for scalp, proximal flexures.
<6months age usually.
Often clears within weeks of treatment
Usually the child doesn’t feel as poorly as a child with eczema, quite happy and well
What is seborrheic dermatitis like in adults?
Chronic dermatitis.
Malassezia yeast increased in the scaly epidermis of dandruff and seborrehoic dermatitis.
Red, sharply marginated lesions covered with greasy looking scales.
Distinctive distribution – areas rich in supply of sebaceous glands (scalp, face, upper trunk).
Usually preceded by dandruff.
Treat with topical anti-yeast (ketoconazole).
If severe, consider HIV test
What is Pompholyx/vesicular eczema?
Palms and soles. Intensely itchy. More common under 40 years. Sudden onset of crops of vesicles. Resolution can include desquamation
What is asteatotic eczema?
Very dry skin. Cracked scaly appearance. Most commonly shins affected. Climate – heat Excessive washing/soaps
How is vascular eczema managed?
Manage actual oedema of leg with compression stockings
What is eczema herpeticum?
Disseminated viral infection Fever and often unwell Itchy clusters of blisters and erosions Herpes Simplex 1 and 2 Swollen lymph glands
Consider admission, antivirals, consider secondary bacterial infection.
How can eczema be treated?
Emollients (moisturisers) Ointment – greasy but effective Creams – lighter Lotions – more watery Soap substitutes Intermittent topical steroids Different potency hydrocortisone (low) Betamethasone (potent) Sometimes need antihistamines or antimicrobials Calcineurin Inhibitors Topical Pimecrolimus and Tacrolimus
What are two treatments used for severe eczema?
Ultraviolet light. Immunosuppression. Azathioprine Ciclosporin Mycophenolate mofetil Methotrexate
