Dermatology Quiz: Eczema and Dermatitis

Integumentary Conditions

• Skin lesions can have various causes, including hereditary factors, physical trauma, systemic conditions like vascular insufficiency or diabetes, burns (thermal, electrical, chemical, inhalation), surgical wound complications, tumors (including paraneoplastic syndromes), radiation reactions, infections, medication reactions, and contact with irritants or allergens.

Signs and Symptoms of Skin Disorders

• Common symptoms include itching (pruritus), hives (urticaria), rashes, blisters, dry skin (xerosis), unusual spots, moles, nodules, cysts, swelling (edema), changes in nail appearance or skin pigmentation, turgor, and texture.

Pruritus (Itching)

• The most common symptom, often due to dry skin (xerosis).
• Can be indicative of underlying systemic diseases, especially in the elderly or chronically ill.
• Assess for scratch marks.
• Patient history regarding scratching and possible systemic issues is important.

Urticaria (Hives)

• A vascular skin reaction characterized by smooth, slightly raised patches (wheals).
• Typically in acute allergic responses.
• Usually resolves within two days; chronic urticaria lasts for weeks to months or years.
• Treatment for allergic responses often involves antihistamines.

Rash

• A general term for skin eruptions.
• Common locations include the face, trunk, armpits, and groin.
• Often accompanied by itching.
• Important to document the appearance of the rash to help diagnose the underlying cause.
• Causes may include allergies, skin exposures, chemical/medical irritants or systemic conditions.

Skin Lesion characteristics

• Size: macule (<5cm), patch (>5cm).
• Elevation: solid, vesicle(<1cm), bulla (>1cm), pustule (contains pus), wheal (transient).
• Depth: superficial, deep (nodule).
• Color: correlated with various conditions (burns, dermatitis, herpes). Important: Refer to other doctors if the problem is beyond the scope of the physical therapist's practice.

Eczema and Dermatitis

• These terms are often used interchangeably to describe superficial skin inflammations.
• Causes include irritant exposure, allergic reactions, and genetic factors.
• Common types include allergic dermatitis, irritant dermatitis, seborrheic dermatitis, nummular eczema, atopic dermatitis (AD), and stasis dermatitis.
• AD is a chronic inflammatory skin disease; AD is the most common type of eczema.

Atopic Dermatitis

• A chronic skin condition, commonly appearing in childhood.
• It is often associated with other allergic conditions (asthma, allergic rhinitis).
• Characterized by dry, thickened, and/or brownish-grey skin (lichenified)
• Children may exhibit a red, oozing, or crusting rash
• Increased IgE serum levels are sometimes present.

Contact Dermatitis

• A skin inflammation caused by contact with irritating or allergenic substances.
• Can be caused by various stimuli (jewelry, leather, wool, rubber, latex, topical antibiotics).
• Often presents with intense itching (pruritus), redness (erythema), and edema.
• May progress to vesiculation, oozing, crusting, or scaling.

Stasis Dermatitis

• Skin condition primarily affecting the lower legs.
• Most commonly caused by venous insufficiency (blood pooling in the legs).
• A history of varicose veins or deep vein thrombosis (DVT) is common.
• Characterized by extremely dry skin, shallow ulcers, and sometimes brown discoloration.

Skin Infections

• Bacterial infections (like Impetigo and cellulitis) and Viral infections (Herpes Zoster) are common.
• Impetigo, superficial skin infection frequently caused by Staphylococcus aureus, is often seen during hot and humid weather.
• Cellulitis is an acute inflammation of skin and subcutaneous tissue, frequently caused by Streptococcus pyogenes or Staphylococcus aureus.
• Herpes Zoster infection, including chickenpox and shingles, results in painful vesicular rashes. Important: Infections can be caused by various factors including decreased resistance, dry skin, burns, pressure ulcers, decreased blood flow, contamination, poor hygiene, and crowded living conditions.

Skin Cancer

• Benign conditions include seborrheic keratosis and nevi (moles).
• Pre-malignant conditions include actinic keratosis and Bowen's disease.
• Non-melanoma skin cancers include basal cell carcinoma and squamous cell carcinoma.
• Malignant melanoma is a serious condition originating from melanocytes and is differentiated by types including superficial spreading, nodular, lentigo maligna, and acral lentiginous.

Cutaneous Lupus Erythematosus

• Chronic inflammatory disorder of connective tissues.
• Two main types: acute and chronic (discoid).
• Photosensitivity (increased skin sensitivity to sunlight) is a common feature.
• Often presents with a characteristic "butterfly" rash (malar rash) over the cheeks and nose.
• Other important symptoms to observe include vasculitis, overwhelming fatigue, arthralgia, fever, arthritis, anemia, hair loss, Raynaud's phenomenon, and/or kidney involvement (Lupus Nephritis)
• Similar to other connective tissue disorders.

Systemic Sclerosis (Scleroderma)

• Chronic connective tissue disorder, causing progressive fibrosis (hardening) of the skin, joints, blood vessels, and internal organs.
• Two types—localized and diffuse.
• Sclerodactyly (thickening and tightening of the skin on fingers and hands) and telangiectasias (dilated blood vessels) are commonly observed.
• Increased collagen deposition causes irreversible changes limiting movement.

Pressure Ulcers

• Occur due to unrelieved pressure resulting in damaged underlying tissue.
• Characterized by various stages based on depth of tissue loss, including intact skin with redness (Stage 1) to full-thickness tissue loss (Stage 4).
• Various factors that predispose an individual for pressure injuries include decreased mobility, poor circulation, poor nutrition/hydration, diabetes and neuro conditions.

Other relevant information

• Skin lesions can also be associated with immunodeficiency syndromes (like psoriasis or disorders related to immune dysregulation), and certain medications, viruses, infections, and nutritional deficiencies.
• If a skin lesion is concerning, a referral to a medical specialist is essential.

Test your knowledge on key concepts related to eczema, dermatitis, and associated skin conditions. This quiz covers definitions, classifications, and common triggers. Perfect for students and professionals in the field of dermatology!