Dermatitis and Eczema Flashcards Preview

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Flashcards in Dermatitis and Eczema Deck (34):
1

contact dermatitis

acute or chronic inflammatory reaction to substance that comes in contact with the skin

2

irritant contact dermatitis (ICD)

chemical irritant, can occur in anyone, confined to areas of exposure, certain threshold above which dermatitis occurs and below which it does not

3

allergic contact dermatitis (ACD)

type IV hypersensitivity reaction to an allergen, spreading reaction, occurs only in sensitized individuals

4

symptoms of acute ICD

burning, stinging, smarting (immediate - acid, chloroform, methanol), can start 1 -2 min, peak at 10 and fade after 30 min (delayed - propylene glycol)

5

presentation of acute ICD

well-demarcated erythema - vesicles and blisters - crusting - erosions, necrosis. NO papules.

6

symptoms of chronic ICD

stinging, smarting, burning AND itching - pain later

7

presentation of chronic ICD

dryness, chapping, erythema - hyperkeratosis and fissuring - lichenification, ill defined borders, crusting

8

treatment for acute ICD

remove offending agent, wet dressings with Burow's solution q 2-3 h, topical glucocorticoids; 60mg red for 2 weeks with 10 mg taper

9

treatment for chronic ICD

remove offending agent, betamthasone or clobetasol; topical calcineurin inhibitors not enough to suppress inflammation

10

phytodermatitis - common offending agents

poison ivy, poison oak - oleoresins called uroshiol

11

derm path: ACD

spongiosis, lymphocytes and eosinophils, chronic - lichenification

12

Atopic dermatitis presentation

pruritus and itching leading to more inflammation and pruritus, lichenification: "itch scratch cycle"

13

AD microbial agents

Staph areus exotoxins, S. pyogenes

14

Skin barrier disruption of AD

defect in filaggrin, decreased ceramides

15

other atopies associated with AD

allergic rhinitis, asthma

16

pathophysiology of AD

type 1 HS reaction mediated by IgE as a result of vasoactive substances released by mast cells and basophils

17

what type of AD is common in black people?

follicular lichenification

18

pathogenesis of lichen simplex chronicus (LSC)

hyper excitability of lichenified skin in response to minimal external stimuli

19

symptoms LSC

pruritus in paroxysms

20

clinical presentation LSC

solid lichenified plaque with confluence of small papules. exoriations. dull red and later brown or black hyperpigmentation

21

path LSC

hyperplasia of all epidermal components: hyperkeratosis, acanthosis, elongated and board rate ridges. chronic inflammatory infiltrate in the dermis

22

mgmt LSC

occlusive bandages at night, topical glucocorticoid prep or tar prep covered by occlusive dressings for legs/arms, Unna boot: gauze roll dressing impregenated with zinc oxide paste wrapped around a large lichenified calf - left for one wee.

23

Prurigo nodularis

associated with AD but occurs without it; starts with piercing pruritus leading to picking and scratching. Multiple, firm, dome shaped nodules with excoriations

24

Tx prurigo nodularis

IL triamcinolone with occlusive dressings; neuron tin 300mg may be helpful

25

Dyshidrotic eczema

vesicular type of hand and foot dermatitis; sudden onset of deep-seated pruritic clear "tapioca-like" vesicles.

26

Nummular Eczema

pruritic coin-shaped plaques composed of papules or vesicles on an erythematous base, esp common in the winter months

27

Nummular eczema tx

hydrate with moisturizer or cream topical GC or 2-5% crude coal tar ointment

28

Autosensitization dermatitis or "id reaction"

generalized pruritic dermatitis directly related to primary dermatitis elsewhere. Primary releases cytokines into blood, heightening the sensitivity of distant skin areas.

29

2 diseases related to increased incidence of seborrheic dermatitis

PD and HIV

30

clinical presentations seborrheic dermatitis

greasy, erythema, yellow-orange scales and crusts on the scalp eyebrows, and beard

31

etiology seborrheic dermatitis

malesszia furfur - tx with ketoconazole or selenium sulfide

32

mineral deficiency that are seborrheic dermatitis-like

zinc (acrodermatitis enteropathica -perioral, diaper area at 6 month old), niacin, pyridoxine deficiency

33

asteatotic dermatitis

common pruritic dermatitis occurs esp in older persons in the winter in temperate climates; dry, "cracked" superficially fissured skin with slight scaling

34

mgmt asteatotic dermatitis

acid hot soapy baths and increasing ambient humidity to >50% with humidifiers