Dermatitis/ Eczema Flashcards

1
Q

What is hyperkeratosis

A

Increased thickness of keratin layer

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2
Q

What is parakeratosis

A

Persistence of nuclei in the keratin layer

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3
Q

What is acanthosis

A

Increased thickness of epidermis

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4
Q

What is papillomatosis

A

Irregular epithelial thickening

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5
Q

What is spongiosis

A

Oedema between keratinocytes

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6
Q

What is inflammatory cell infiltrate

A

Acute or chronic lymphocytes and/ or neutrophils

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7
Q

What is the main symptom/ sign of eczema

A

ITCH

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8
Q

What happens in the acute phase of eczema

A

Papulovesicular
erythematous lesions
eodema / spongiosis
Ooze or scaling and crusting

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9
Q

What happens in the chronic phase of eczema

A

Thickening (lichenification)
Elevated plaques
Increased scaling

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10
Q

Drug related dermatitis shows what histologically

A

spongiotic dermatitis and eosinophils

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11
Q

What is the pathogenesis of atopic dermatitis

A

Genetic and environmental factors resulting in inflammation

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12
Q

What is the pathogenesis of contact allergic

A

Delayed type hypersensitivity reaction (type 4)

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13
Q

What is one of the most common types of dermatitis

A

Contact allergic - response to chemicals, topical therapies, nickel, plants etc.

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14
Q

What are 2 common causes of facial contact dermatitis

A

Make up or air-borne

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15
Q

Why does weeping eczema occur

A

Caused by oedema between the keratinocytes

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16
Q

What do Langerhans cells in the epidermis do?

A

They process the antigen

17
Q

What happens when the langerhans cell has processed the antigen

A

It is presented to the Th cells in the dermis

18
Q

What happens when the Th cells become sensitised

A

They migrate into the lymphatics and then to regional nodes where the antigen presentation is amplified

19
Q

How can specific substances causing contact dermatitis be identified?

A

Patch Testing

20
Q

What is it called when sensitised T-cells proliferate and migrate to and infiltrate the skin

A

Dermatitis

21
Q

How long after the patch testing has started are the reactions checked

A

96 hours later

22
Q

How long are the allergens left on the skin for

A

48 hours

23
Q

What type of reaction is irritant dematitis

A

Non-specific physical irritation rather than a specific allergic reaction

24
Q

What types of things can cause Irritant dermatitis

A
Soap 
Detergent
cleaning products
water
oil
25
Q

What clinical features can occur with hand dermatitis

A
swelling
scaling
erythematous
increased skin markings
fissuring
26
Q

What causes nappy rash

A

irritant contact dematitis to urine

27
Q

What percentage of school aged children are affected by atopic eczema

A

25%

28
Q

What other diseases is atopic eczema associated with

A

asthma
allergic rhinitis
food allergy

29
Q

What flexure is typically affected in atopic eczema

A

Flexure underneath the ear lobe

30
Q

What are the 3 chronic changes in atopic eczema

A

lichenification
excoriation
secondary infection

31
Q

What organism usually causes the secondary infection

A

Staph aureus

32
Q

What causes eczema herpeticum

A

Herpes simplex virus

33
Q

What can be seen in eczema herpeticum

A

monomorphic punched out lesions

34
Q

What is the treatment of eczema

A
plenty of emollients 
avoid irritants including shower gels and soaps 
topical steroids
treat infection
phototherapy - mainly UVB 
systemic immunosuppressants
35
Q

What causes atopic eczema

A

Multiple genetic and environmental factors

36
Q

What gene is most important in atopic eczema

A

filaggrin

37
Q

What can be seen in photosensitive eczema

A

Cut off at collar

38
Q

Where is a common place to see pompholyx eczema

A

Down the side of the digits

39
Q

What causes lichen simplex

A

When the patient scratches their skin often enough. Often seen on the back of the neck