Eczema

Question 1

Eczema usually refers to

Answer 1

severely inflamed dermatitis, and signs and symptoms associated with the process (itching, sting, burning of the skin with drainage form lesions)

Question 2

Cardinal features of inflammation?

Answer 2

• Calor (heat); increased blood flow
• Dolor (pain); irritation of nerves in inflamed tissues
• Rubor (redness); dilated blood vessels

Question 3

What are the three types of dermatitis?

Answer 3

1. Allergy contact dermatitis
2. Irritant contact dermatitis
3. Atopic dermatitis

Question 4

What is the impact of contact dermatitis? commonest type?

Answer 4

• It is the most commonest specific skin disorder encountered.
• T lymphocyte mediated type IV allergic reaction

Question 5

What are the clinical features of Type VI allergy reaction?

Answer 5

• prior exposure is essential
• prolonged contact of substance with skin
• reaction may spread widely from contact area
• only in pre disposed subjects
• no history of allergy

Question 6

Name some common Type IV allergens

Answer 6

Nickel; jewellery, foods

Benzocaine; anaesthetics

Question 7

What is the treatment for allergy contact dermatitis?

Answer 7

• AVOIDANCE!
• compresses
• oral antibiotics
• oral antihistamines
• oral corticosteroids
• topical corticosteroids
• topical emollients

Question 8

Clinical features of irritant contact dermatitis?

Answer 8

• non immunologic inflammatory reaction of the skin due to an external agent
• may be chemical or irritant
• reaction localised to area
• almost everyone is susceptible
• onset seen 4- 12 hours after contact
• may occur of 1st contact
• varied morphology

Question 9

What may irritant contact dermatitis be caused by?

Answer 9

Water, soaps, detergents, bleaches, acids and alkalis, solvents and hydrocarbons, fibreglass, dust, teargas, metal salts

Question 10

Predisposing factors for irritant contact dermatitis?

Answer 10

• history of atopic dermatitis
• occupational exposure/ repeated exposure
• low temp/ low humidity
• skin condition

Question 11

Treatment of ICD?

Answer 11

• Define/ remove exposure
• Oral antihistamines
• Barrier creams
• Topical corticosteroids

Question 12

Atopic dermatitis is a common

Answer 12

immune-mediated inflammatory skin disorder. It has multifactorial aetiology including:

• interactions of genes and environment
• family history of disease
• IgE mediated

Question 13

The atopic triad includes

Answer 13

hay-fever
asthma
eczema

Question 14

Atopic dermatitis: signs and symptoms

Answer 14

itching
dry, scaly skin.
redness + swelling of skin
thickening of skin

Question 15

Location of dermatitis?

Answer 15

Back of knees/ bend of elbows
Face
Neck
Outer part of ankle

Question 16

Triggers for atopic dermatitis?

Answer 16

• anxiety/stress
• climatic factors; humidity/ temp
• irritants; detergents/ solvents
• allergens; contact/ food/ inhalation
• infections (staph + strep)

Question 17

management of MILD atopic eczema?

Answer 17

emollients

mild potency topical corticosteroid

Question 18

management of MODERATE atopic eczema?

Answer 18

emollients
moderate potency topical corticosteroids
bandages
topical calcineurin inhibitors

Question 19

management of SEVERE atopic eczema?

Answer 19

emollients
potent topical corticosteroids
bandages
phototherapy
systemic therapy

Question 20

What are some limitations to topical steroid therapy?

Answer 20

Skin side effects; atrophy, telangiectasia, striae
Skin infections
Risk of cataracts/ glaucoma
Cushing syndrome and growth retardation