Allergies at Home and Work Flashcards

1
Q

What is the difference between Atopic Dermatitis and Contact Dermatitis?

A

Contact dermatitis - external cause

Atopic dermatitis - internal cause.

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2
Q

What is the difference between Allergic Contact Dermatitis and Irritant Contact Dermatitis?

A
  • Allergic Contact Dermatitis - contact to the skin has previously caused a type 4 immune mediated hypersensitivity reaction.
  • Irritant Contact Dermatitis - due to direct irritant on the skin.
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3
Q

What are the substances that most commonly cause irritant contact dermatitis? ICD

A
  1. Water
  2. Detergents
  3. Soaps
  4. Solvents
  5. Abrasives
  6. Alkalis
  7. Acids
  8. Cement
  9. Cutting oils
  10. Plants
  11. Dust
  12. Soil
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4
Q

What % of men and women have hand eczema?

A

5% of men and 10% of women have hand eczema.

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5
Q

What is the most common area of the body to get irritant contact dermatitis?

A

Hands

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6
Q

Is this Irritant Contact Dermatitis or Allergic Contact Dermatitis?

A

This is Irritant Contact Dermatitis due to the soap collecting underneath the ring.

Allergic Contact Dermatitis would be due to a nickel allergy and would look different.

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7
Q

What is this and what causes it?

A

Eczema Craqulee

It is usually due to chronic episodes of ICD - where the skin hasn’t healed properly.

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8
Q

How does one manage irritant dermatitis?

A

Prevention is key

  • Use gloves.
  • Treat flares with topical steroids.
  • Treat secondary infections
  • KNMO4 soaks for pompholyx eczema.
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9
Q

What is the pathophysiology of Allergic Contact Dermatitis (ACD)?

A

It is a Type 4 Hypersensitivity Reaction.

Langerhans cells in the epidermis present the antigen to the T Lymphocytes and then sensitisation occurs.

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10
Q

What is the management for Allergic Contact Dermatitis?

A
  1. Detect the likely sensitising agent.
  2. Patch testing - once dermatitis has settled down.
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11
Q

What is used in a patch test?

A

The European Standard Battery Test (ESB)

is composed of 35-38 different substances

which are the most common to cause ACD.

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12
Q

Where are the patch tests placed?

A

On the back

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13
Q

How long is the skin patch left on for?

A

48 hours

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14
Q

When are the skin patches read by the Doctor?

A

At 72-96 hours.

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15
Q

What are some other sorts of patch tests? (specialist tests)

A

Some specialists kits include:

The Florist series.

The Dental series.

The hairdresser series

etc.

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16
Q

Who should be patch tested?

A

Patients who have the following patterns of eczema:

  • Eyelid, face, perioral
  • Otitis externa
  • Gand/foot dermatitis
  • Perianal or genital eczema
  • Unusual/ asymmetrical patterns of eczema
  • Sudden deterioration of long-standing eczema
  • Certain occupations (see above)
17
Q

What are the most common contact allergens?

A
  1. Nickel
  2. Chromate (in cement, plaster, leather matches, polish)
18
Q

What are the 3 most common culprits for foot ACD?

A
  1. Chromate
  2. p-tert-Butylphenol-formaldehyde resin - shoe adhesive.
  3. Thiuram - leather accelerators.
19
Q

What are the types of hand dermatitis and their causes?

A
  1. Irritant Contact Dermatitis - powder/soap/gloves/sweaty hands.
  2. ACD - thiuram accelerator in leather gloves.
  3. Type 1 Allergy to latex
    • ​​Detected by prick testing or RAST IgE test.
20
Q

If someone has a latex allergy, what should they be told to avoid?

A

Rubber balloons

Swimming hats

Rubber Contraceptives (cap and condom)

Latex gloves.

21
Q

What is the chemical in hair dyes and henna that can cause an allergic reaction?

A

Paraphenylenediamine (PPD)

22
Q

What are some causes of anogenital dermatitis?

A
  • Haemorrhoid creams (which contain LA)
  • Antiseptics (Chlorhexidine)
  • Antibiotics (neomycin)
23
Q

If someone has anogenital dermatitis and demands to see a dermatologist,

what should you do?

A

Refer

  • have a low threshold for referral.
24
Q

What can be used in the patch test to see if someone has an allergy to steroids?

A

Tixocortol Pivalate.

25
Q

If someone shows an allergy to tixocortol pivalate, what should they avoid and what can they still use?

A

Avoid: Dermovate and Hydrocortisone.

Safe to use: Betnovate and Mometasone.

26
Q
A