Eczema and dermatitis

Question 1

Dermatitis features

Answer 1

Pruritic papaulovesicular which has acute acute (erythema, vesiculation, weeping ,edema) and chronic (thickening, lichenification, scaling) features

Question 2

Chronic histologic features of Eczema

Answer 2

hyperkeratosis, irregular acanthosis of epidermis, thickening of collagen bundles in papaillary dermis(scar)

Question 3

Acanthosis:

Answer 3

Epidermal thickening or widening

Question 4

Exocytosis

Answer 4

edema and serous exudate between epidermal cells

Question 5

Subcorneal pustule

Answer 5

(neutrophils and bacteria) => secondary

impetignization; not always present

Question 6

eczema will have similar chronic

histologic features:

Answer 6

• Hyperkeratosis
• Irregular acanthosis of epidermis
• Thickening of collagen bundles in papillary dermis (scar)

Question 7

End stage of any eczema

Answer 7

LSC

Question 8

Reaction to a chemical in a potent concentration in a sufficient length of time. No allergic mechanisms

Answer 8

Irrititant Contact Dermatitis

Question 9

provoking substantces in ICD

Answer 9

Acids/alkalis, metallic elements salts, essential oils, detergent,organic solvent, excessive water exposuire

Question 10

ACD is what tyoe if hypersensitivity

Answer 10

Delayed type hypersensitivity
(Type IV) - mediated by Tlymphocytes
(memory); may
persist forever

Question 11

plant dermatitis and metal dermatitis

Answer 11

PD: linera configuration…. MD: nickel and <18K gold

Question 12

Locations of eczema

Answer 12

nipple (bilateral in the young with family hx), ear,eyelid, diaper,hand,mucous membrane

Question 13

medicine that causes photocontact dermatitis

Answer 13

clindamycin, tetracycline,doxycycline

Question 14

2 types of photocontact dermatitis

Answer 14

Phototoxic(ICD) and photoallergic(ACD)

Question 15

Sx and symtons of CD

Answer 15

• Always has pruritus (acute,subacute,chronic)

Question 16

Patch test

Answer 16

Applications of specific allergens directly to skin

Question 17

other name for ATopic Dermatitis

Answer 17

Besnier’s prurigo

Question 18

Endogenous Dermatitis

Answer 18

• Atopic dermatitis
• Seborrheic
Dermatitis
• Nummular
Dermatitis
• Dishydrotic Eczema
• Static Dermatitis

Question 19

usually found in the chronic stage and always generalize. Increased IgE-mediated immune response in early stages which develop to defective T-Cells in later stages

Answer 19

Atopic Dermatitis

Question 20

Genetic predisposition in AD

Answer 20

Filaggrin gene for filament aggregatigng protein, atopic skin becomes like a sieve, increased IgE mediatied response

Question 21

Essential elements of AD (PEC)

Answer 21

Pruritus, Chronicity,, characteristic Eczema

Question 22

3 stages if AD and their involvement

Answer 22

Infantile= Extensors, Childhood = Flexural, Adult = antecubitals, popliteals

Question 23

Associated conditions of AD

Answer 23

KEratosis Pilaris (this autosomal dominant), Pityriasis Alba (reddish patch becming hypopigmented through time)

Question 24

How to determine pityriasis versicolor

Answer 24

Fingernail test, KOH

Question 25

test for leprosy for kids

Answer 25

Let them play outside,if not sweaty, positive

Question 26

Seborrheic dermatitis also known as

Answer 26

Seborrhea

Question 27

Yellowish or grayish, sharply marginated macules covered with greasy scales

Answer 27

seborrhea

Question 28

Coalesce to form irregular patches, found in greater sebaceous areas

Answer 28

SD

Question 29

Factors of SD

Answer 29

STress, HPN,diabetes, Dyslipedemia, HIV, Infection, Weather cahnges, ROH

Question 30

Dyshidrosis, cheiropopomoyx,phompholyx features

Answer 30

Recalcitrant, deep-seated vesicular eruptions on the palms and soles( Dyshidrotic = palmar,planter)

Question 31

DDX for Dyshidrotic dermatitis

Answer 31

Tinea,(different tx since DD is steroids)

Question 32

Accompanied by Hemosiderin and lipdermatosclerosis

Answer 32

STasis dermatitis

Question 33

PAthophysio of Stasis Dermatitis

Answer 33

V.insuffciency => Pooling of blood => Varicosities => Varicose edema => Static dermatitis • Poor nutrition (deoxygenated blood) which leads to dryness, itchiness and edema

Question 34

Unclassified dermatitis and 1 feature

Answer 34

Astetotic Eczema (crazy paving), neurodermatitis(single fixed lichenified plaque, Prurigo nodularis( one finger used instead of five)

Question 35

DDX of Eczema: Fungal infection

Answer 35

has a clear center, advancing border with papules | and pruritus is not present all the time

Question 36

interdigital webs

Answer 36

Tinea Pedis

Question 37

psoriasis

Answer 37

with Auspitz’s sign, silvery scales but sometimes shows | as red papules so harder to differentiate from eczema

Question 38

Zinc deficiency

Answer 38

Acrodermatitis enteropathica

Question 39

Histiocytosis X

Answer 39

bad case of seborrhea, it can present like a cradle cap, should be spotted early. When you see a baby in the ward with petecchial lesions on the soles and hands with hepatomegaly, think HX

Question 40

Management

Answer 40

Dressings, Dessicants, topical steroids,Oral antihistamines,systemic steroids, immunomodulators,• Ancillary o Antibiotics o Emollients – use for dry skin (atopic dermatitis and eczema craquele or asteatotic eczema)

Question 41

patient info

Answer 41

• Ancillary o Antibiotics o Emollients – use for dry skin (atopic dermatitis and eczema craquele or asteatotic eczema) • Try to identify contactants, educate patients to avoid them and stop scratching; otherwise, useless treatment