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D&D Unit 4 > Inflammatory Skin Disease (complete) > Flashcards

Inflammatory Skin Disease (complete) Flashcards

(51 cards)

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1
Q

What are common causes of irritant and allergic contact dermatitis?

A

1) Atopic Dermatitis

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2
Q

What is atopic dermatitis?

A
  • Common skin disease

- Can begin at any age (majority <5yo)

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3
Q

What are the diagnostic criteria for atopic dermatitis?

A

MUST HAVE: itchy skin and three or more of the following:

  • H/o of skin crease involvement
  • H/o asthma or hay fever
  • H/o dry skin in last year
  • Visible flexural eczema
  • Onset under 2 years
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4
Q

What is the pathogenesis of atopic dermatitis?

A
  • Barrier disrupted skin
  • Filaggrin mutation
  • S. aureus acts as superAg
  • Elevated IgE
  • Eosinophilia
  • Th2 cytokine production (IL4,5,&10)
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5
Q

Describe infantile atopic dermatitis

A

Birth - 2 yo

  • Dry, red scaly areas — confined to cheeks
  • Becomes flushed w/ exposure to cold
  • Some will have a generalized eruption (erythematous papules, redness, scaling, areas of lichenification)
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6
Q

Describe childhood atopic dermatitis

A

Involvement of flexural skin

  • antecubital fossa
  • popliteal fossa
  • neck
  • wrists
  • ankles
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7
Q

Describe adult atopic dermatitis

A
  • occurs on eyelid and/or hand

Characterized by:

  • dry skin
  • keratosis pilaris
  • ichthyosis vulgaris
  • hyperlinearity of palms
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8
Q

Describe irritant contact dermatitis

A
  • non-immunological mediated rxn => direct cytotoxic effect
  • Can be from a single/repeated exposure
  • MOST COMMON type of contact dermatitis

No specific test for irritant contact dermatitis

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9
Q

What are the effects of strong irritants associated w/ irritant contact dermatitis?

A
  • Damage skin directly (even w/ small amounts for short time)
  • These agents carry warning labels => suggest wearing gloves

Weak irritants are harmless by themselves but frequent contact may damage skin

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10
Q

What are some examples of weak irritants?

A
  • Soap/water
  • Skin products
  • Perfumes
  • Wool
  • Raw foods
  • Body secretion
  • Friction
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11
Q

Describe allergic contact dermatitis

A
  • Requires exposure of allergen => immune response & development of memory T cells
  • Type 4 delayed-type hypersensitivity rxn => starts 24-48hrs after exposure

Think poison ivy

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12
Q

Describe allergic contact dermatitis on a micro level

A
  • Allergens small chemicals => <500 daltons
  • Smallness allows penetration through skin
  • Langerhans cells present allergen to T cells
  • Require repeat exposure
  • Caused by inflammatory cytokines including TNF-alpha and IL-1
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13
Q

What do you patch test?

A
  • Used for diagnosing allergic contact dermatitis
  • pts have suggestive history
  • pts w/ resistant dermatitis
  • chronic dermatitis
  • occupationally related dermatitis
  • Atopic eczema
  • stasis dermatitis
  • photo/airborne distribution
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14
Q

What are some contact allergens?

A
  • Nickel
  • Balsma of Peru
  • Neomycin
  • Fragrances
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15
Q

What are some risk factors associated with nickel sensitivity?

A
  • Being female
  • Younger age
  • Ear piercing
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16
Q

Describe fragrance allergies

A
  • > 2800 fragrance ingredients
  • > 100 are known contact allergens
  • Unscented products may have a masking fragrance — need to use fragrance-free products
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17
Q

Describe bacitracin and neomycin allergies

A
  • Can occur together

- Co-sensitization: allergy to two allergens not structurally related but often used together

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18
Q

What are drug eruptions?

A

Delayed-typer hypersensitivity rxns

  • Most common type
  • Usually Type 4 hypersensitivity

Usually begins 7-14 days after starting new med

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19
Q

Describe exanthematous eruptions

A
  • 10-20% in children are drug-induced
  • 50-70% in adults are drug-induced

Tx: stop cause (infection), supportive w/ topical steroids, anti-histamines

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20
Q

What are some responsible drugs associated with exanthematous eruptions?

A
  • AminoPCNs
  • Sulfonamides
  • Cephalosporins
  • Anticonvulsants
  • Allopurinol
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21
Q

Describe stasis dermatitis

Study These Flashcards
A
  • Associated w/ other signs of venous insufficiency
  • ONLY in lower extrememties

Think:

  • Varicose veins
  • Chronic lower extremity edema
  • Venous stasis ulcers
  • Lipodermatosclerosis
22
Q

What are complicating factors associated with stasis dermatitis?

Study These Flashcards
A
  • dryness
  • itching
  • allergic contact dermatitis
  • irritant dermatitis due to wound exudates
23
Q

What is the treatment for stasis dermatitis

Study These Flashcards
A
  • Compression
  • Elevation
  • Exercise calf muscles
  • Vascular surgery
  • Topical steroids
  • Avoid allergens
24
Q

What is lichen simplex chronicus?

Study These Flashcards
A
  • thick, scaly plaques
  • Cause: chronic rubbing, scratching
  • Tx: topical steroids first, then antihistamines

Pts need to be counseled to break cycle

25
Describe venous stasis ulcers
- Common in pts w/ h/o leg edema, varicose veins, blood clots - Found in medial lower leg - Red w/ yellow fibrinous base - Borders irregularly shaped - May be purulent
26
Describe nummular dermatitis
AKA: discoid eczema - Often in legs, but also arms, trunk - Most common in men >50yo - round patches: red, scaly, crusty - Tx: moisturization, minimize soap, topical steroids
27
What is the morphology of dermatitis?
- Erythematous papules | - Thin plaques w/ scale
28
What is the morphology of erysipelas?
Warm, tender, erythematous, sharply demarcated, raised plaque
29
What is the morphology of cellulitis?
Warm, tender, erythematous patches OR plaques
30
Where is the inflammation in dermatitis?
- Epidermis | - Dermis
31
Where is the inflammation in erysipelas?
- Dermis | - minimal SubQ tissue
32
Where is the inflammation in cellulitis?
- Dermis | - SubQ tissue
33
Describe seborrheic dermatitis
- Facial involvement - Symmetric over medial eyebrows, nasolabial folds, ears - Occurs in areas w/ sebaceous glands (scalp, face, ears, chest) - ALSO dandruff
34
Describe the pathogenesis of seborrheic dermatitis
- Maybe b/c of a combo of overproduction of skin oil and yeast irritation (malassezia furfur) - Increased disease linked to Parkinsons, head injury, stroke, HIV
35
Describe psoriasis
- Affects 2% of pop'n - Positive FH in 36% of psoriasis - Impacts QOL Clinical: - Chronic plaque disease - Guttate - Erythroderma - Pustular psoriasis - Arthritis
36
What are co-morbidities associated w/ psoriasis?
- Independent risk factor for CV disease | - Pts in 40s: double risk for MI, RR increases by 20%
37
Describe the treatment in localized psoriasis
- Calcipotriol - Corticosteroids - Topical retinoids - Phototherapy
38
Describe the treatment in widespread psoriasis w/ or w/o arthritis
- Methotrexate - Cyclosporin - Systemic retinoids
39
CHEAT SHEET Where does stasis derm present?
Lower legs
40
CHEAT SHEET Where does seborrheic derm present?
Scalp
41
CHEAT SHEET Where does atopic derm present?
Flexor surfaces
42
CHEAT SHEET Where does psoriasis present?
Extensor surfaces May include arthritis
43
CHEAT SHEET What is the cause of stasis derm?
Lower extremity edema
44
CHEAT SHEET What is the cause of seborrheic derm?
Malassezia furfur
45
CHEAT SHEET What is the cause of atopic derm?
Filaggrin
46
CHEAT SHEET What is the cause of irritant derm?
Common irritants
47
CHEAT SHEET What is the cause of allergic contact derm?
Common allergens
48
CHEAT SHEET What is atopic dermatitis associated with?
Asthma Allergic rhinitis
49
CHEAT SHEET What type of hypersensitivity is associated with allergic contact dermatitis?
Type 4 (delayed type hypersens rxn)
50
CHEAT SHEET How is allergic contact dermatitis tested for?
Patch testing
51
CHEAT SHEET What is psoriasis associated with?
Increased risk for CV disease

D&D Unit 4 (18 decks)

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