Eczema and Dermatitis

Question 1

Investigation for allergic contact dermatitis?

Answer 1

patch testing

Question 2

Distribution of atopic eczema in older children and adults

Answer 2

flexural surfaces

Question 3

What is this condition?

Answer 3

Contact allergic dermatitis

Question 4

Common infections associated with eczema? (2)

Answer 4

staph. aureus; herpes simplex virus

Question 5

Difference between contact allergic and irritant dermatitis

Answer 5

Irritant does not require prior exposure and may occur due to milder irritants

Question 6

T cells affected in eczema

Answer 6

Th2

Question 7

Clues that allergic contact dermatitis may be workplace associated?

Answer 7

clears up on holiday

Question 8

More extreme treatment of eczema

Answer 8

phototherapy, immunosuppressants and biologic agents

Question 9

Appearance of eczema herpeticum

Answer 9

monomorphic punched out lesions

Question 10

Condition where eczema and herpes simplex virus are combined

Answer 10

eczema herpeticum

Question 11

Pathogenic mechanism behind allergic contact dermatitis

Answer 11

langherhans cells process and present the antigen at the regional lymph nodes and activate naive CD4 T cells. This results in the production of effector and memory T cells which produce a response to future exposures within 48-96 hours.

Question 12

Atopic eczema is associated with what other diseases? (3)

Answer 12

asthma, allergic rhinitis, food allergy

Question 13

Example of emollients

Answer 13

Diprobase, Dermol, Epaderm, E45

Question 14

Appearance of skin in a person with eczema

Answer 14

dry, erythematous, scaling, lichenification, excoriations

Question 15

Allergic contact dermatitis requires…?

Answer 15

prior exposure

Question 16

Diagnostic criteria for eczema is itching plus 3 or more of…?

Answer 16

visible flexural rash (children/adults), history of a flexural rash, PMH or close family history of atopy, generally dry skin, onset before age 2

Question 17

Papule

Answer 17

raised area <0.5cm

Question 18

What is this condition called?

Answer 18

Atopic eczema

Question 19

Treatment of allergic contact dermatitis?

Answer 19

avoidance; topical steroids where more severe; topical calcineurin inhibitors and emollients to moisturise

Question 20

Common condition associated with allergic contact dermatitis?

Answer 20

atopic eczema

Question 21

Localisation of a rash associated with allergic contact dermatitis?

Answer 21

tends to be localised to areas of exposure

Question 22

Common workforces to be affected by allergic contact dermatitis?

Answer 22

hairdresses; beauticians; manual and farm labourers, health care professionals, cleaners, food industry workers

Question 23

Discoid eczema in brief

Answer 23

eczema in unusual but well defined disc shape

Question 24

Treatment for eczema herpeticum

Answer 24

IV antivirals i.e. aciclovir

Question 25

Protein highly affected in eczema

Answer 25

Filaggrin

Question 26

Common presentation of allergic contact dermatitis

Answer 26

pruritis, erythema, vesicles/bullae (rare but may also have: urticaria, pustules, lichenoid lesions and ulceration)

Question 27

Cytokines affected by eczema

Answer 27

IL - 4, 5, 13

Question 28

Spongiosis

Answer 28

oedema between the keratinocytes

Question 29

Appearance of eczema with staph. aureus

Answer 29

golden crusting around infected area

Question 30

Distribution of atopic eczema in young babies and infants

Answer 30

cheeks, scalp, extensor surfaces, neck

Question 31

Seborhheic eczema in brief

Answer 31

appears in oily skin areas, may look like dandruff on scalp, redness and greasy, swollen skin.

Question 32

How might atopic eczema affect quality of life?

Answer 32

itching may lead to poor sleep and poor cognitive function, in children this may affect the whole family

Question 33

Common causes of allergic contact dermatitis

Answer 33

nickel, plants, topical therapies, chemicals, gold, cobalt

Question 34

Treatment of eczema in the beginning

Answer 34

Emolients, avoiding irritants, topical steroids where needed, phototherapy if needed

Question 35

Defining feature of eczema

Answer 35

it is itchy

Question 36

Vesicular

Answer 36

oedema vesicle \<0.5cm

Question 37

What are the scratch marks seen here called?

Answer 37

Excoriations