Eczema and Dermatitis Overview
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Questions and Answers

What distinguishes allergic contact dermatitis (ACD) from irritant contact dermatitis (ICD)?

  • ICD occurs only in atopic individuals.
  • ACD is caused by direct exposure to irritants.
  • ACD is a result of hypersensitivity to a sensitizing agent. (correct)
  • ICD results from an immunologic reaction.

Which of the following is a common causative agent of irritant contact dermatitis (ICD)?

  • Soap (correct)
  • Rubber (correct)
  • Nickel
  • Chromate

When seeking to assess contact dermatitis in a patient, which of the following should a pharmacist inquire about?

  • The patient's allergies to medications.
  • Whether the patient uses sunscreen.
  • The patient's family history of skin conditions.
  • The onset of the rash and agents handheld. (correct)

What is a key differentiating feature of dermatitis compared to eczema?

<p>Dermatitis requires an external precipitating factor. (A)</p> Signup and view all the answers

What indicates the need for referral in patients with contact dermatitis?

<p>A rash that has been present for more than 2 weeks. (C)</p> Signup and view all the answers

Which of the following is least likely to be a common location for irritant contact dermatitis (ICD)?

<p>Diaper area (A)</p> Signup and view all the answers

What is the minimum age requirement for prescribing hydrocortisone in the UK?

<p>10 years (A)</p> Signup and view all the answers

Which type of contact dermatitis involves a less important concentration of the substance at the time of exposure?

<p>Allergic contact dermatitis (C)</p> Signup and view all the answers

For how long can hydrocortisone be used in Canada?

<p>2 weeks (A)</p> Signup and view all the answers

What is a possible symptom indicating severe contact dermatitis that would necessitate referral?

<p>Signs of bacterial infection, such as weeping. (A)</p> Signup and view all the answers

What type of skin should hydrocortisone not be applied to?

<p>Facial skin (C)</p> Signup and view all the answers

How often can hydrocortisone cream be applied per day?

<p>2 to 4 times (A)</p> Signup and view all the answers

What is a fingertip unit used for?

<p>Measuring cream application area (D)</p> Signup and view all the answers

Which of the following is a known sensitizer that should not be used in topical ointments?

<p>Benzocaine (C)</p> Signup and view all the answers

What is the effect of hydrocortisone on protein synthesis in human skin?

<p>It has no effect on protein synthesis (B)</p> Signup and view all the answers

Is the use of hydrocortisone during pregnancy considered safe?

<p>Yes, it is OK (C)</p> Signup and view all the answers

What characterizes mild acne?

<p>Predominantly open and closed comedones with few inflammatory lesions (A)</p> Signup and view all the answers

When should a patient with moderate acne be referred?

<p>If lesions are painful and widespread (A)</p> Signup and view all the answers

What additional condition is indicative of severe acne?

<p>Development of cysts (C)</p> Signup and view all the answers

Which factor might lead a patient to be referred for acne treatment?

<p>Acne beginning outside the normal age range (B)</p> Signup and view all the answers

What is NOT a characteristic of rosacea?

<p>Presence of comedones (A)</p> Signup and view all the answers

Which medication is frequently associated with acne-like lesions?

<p>Topical steroids (C)</p> Signup and view all the answers

Which of these conditions requires referral to a doctor?

<p>Patient with mild acne not responding after 8 weeks (D)</p> Signup and view all the answers

What is a potential cause of occupational acne?

<p>Long-term contact with oils (C)</p> Signup and view all the answers

What is the primary purpose of benzoyl peroxide in acne treatment?

<p>To prevent new lesions from forming (A)</p> Signup and view all the answers

Which concentration of benzoyl peroxide is recommended to start treatment?

<p>2.5% (D)</p> Signup and view all the answers

What type of skin formulation is generally more suitable for oily skin?

<p>Gels (C)</p> Signup and view all the answers

What should patients be warned about after starting benzoyl peroxide treatment?

<p>It may lead to skin reddening and soreness (A)</p> Signup and view all the answers

How should benzoyl peroxide be applied to be most effective?

<p>Over the entire affected area (B)</p> Signup and view all the answers

What adverse effect can occur with sensitization to benzoyl peroxide?

<p>Redness and inflammation of the skin (D)</p> Signup and view all the answers

Which statement about retinoids in acne treatment is accurate?

<p>They stimulate epithelial cell turnover (B)</p> Signup and view all the answers

What risk is associated with using benzoyl peroxide in relation to clothing and bedding?

<p>It may lead to discoloration or bleaching (B)</p> Signup and view all the answers

What percentage of Adapalene is in Differin Gel, which is available over the counter for acne treatment?

<p>0.1% (D)</p> Signup and view all the answers

What is essential for patients using Adapalene cream to protect against photoirritation?

<p>Sun avoidance and sunscreen use (B)</p> Signup and view all the answers

Which statement regarding diet and acne is accurate?

<p>There is no evidence linking diet with acne. (B)</p> Signup and view all the answers

What is recommended to ensure maximum benefit from acne treatments?

<p>Continuous treatment for up to 6 months may be required. (D)</p> Signup and view all the answers

What is a common misconception about acne and skin hygiene?

<p>Acne is caused by poor hygiene. (B)</p> Signup and view all the answers

Why is the use of topical hydrocortisone contraindicated in acne?

<p>It potentiates the effects of androgenic hormones. (C)</p> Signup and view all the answers

What type of make-up is considered better for individuals with acne?

<p>Water-based foundations (C)</p> Signup and view all the answers

Which demographic is primarily affected by scabies?

<p>Poor communities (B)</p> Signup and view all the answers

What is the primary method of scabies transmission?

<p>Close personal contact (C)</p> Signup and view all the answers

How long can the scabies mite live after leaving its host?

<p>Around 1 day (B)</p> Signup and view all the answers

What is the first choice treatment for eradicating scabies infection?

<p>Permethrin cream (A)</p> Signup and view all the answers

Which of the following is a recommended precaution after treating scabies?

<p>Washing bedclothes at a minimum temperature of 50◦C (A)</p> Signup and view all the answers

What measure should be taken if there is no visible improvement after 3 months of daily use of benzoyl peroxide?

<p>Consult a physician (D)</p> Signup and view all the answers

What is the recommended timeframe for visible benefits from keratolytic treatments like benzoyl peroxide?

<p>6–8 weeks (C)</p> Signup and view all the answers

Which action should be avoided when using benzoyl peroxide?

<p>Minimal contact with eyes and mucous membranes (A)</p> Signup and view all the answers

What should patients be advised regarding the use of benzoyl peroxide at night?

<p>To use white sheets and pillowcases (B)</p> Signup and view all the answers

Flashcards

Contact Dermatitis

A skin condition, like eczema, caused by an external irritant or allergic reaction. Characterized by dryness, redness, and itching.

Irritant Contact Dermatitis (ICD)

The most common type. Skin irritation caused by direct damage from a substance, regardless of allergy.

Allergic Contact Dermatitis (ACD)

Skin irritation from an allergic reaction to a substance, resulting in hypersensitivity.

ICD Causative Agents

Substances like water, detergents, soaps, alkalis, acids, solvents, and some plants that directly harm the skin.

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ACD Causative Agents

Substances causing allergic reactions, like metals (chromium, nickel), dyes, and certain medications.

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Duration of Concern

Contact dermatitis lasting more than two weeks warrants referral to a doctor.

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Severe Contact Dermatitis

Contact dermatitis marked by severely cracked and/or bleeding skin, or bacterial infections (weeping), which needs medical attention.

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Patient Assessment for Contact Dermatitis

Evaluating patient's work/hobbies, rash location/onset, to determine if contact dermatitis is present and to guide referral.

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Hydrocortisone age limit (UK)

Patients must be over 10 years old to use hydrocortisone in the UK.

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Clobetasone age limit (UK)

Patients must be over 12 years old to use clobetasone in the UK.

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Maximum hydrocortisone treatment duration (UK)

Hydrocortisone treatment in the UK should not exceed 1 week.

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Cream vs. Ointment for topical steroids

Creams are often preferred for topical steroid treatment due to patient preference for a less greasy preparation.

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Hydrocortisone application frequency

Hydrocortisone can be applied 2-4 times per day.

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Clobetasone application frequency

Clobetasone should be applied twice a day.

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Topical steroid application amount

Use a fingertip unit (distance from fingertip to first crease) to cover an area twice the size of a flat hand.

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Topical steroid use during pregnancy

Topical steroids are generally safe during pregnancy.

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Mild Acne Characteristics

Predominantly open and closed comedones, few inflammatory lesions (papules/pustules), mainly on the face. No nodules.

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Moderate Acne

Many inflammatory lesions, not limited to the face, often painful, risk of mild scarring.

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Severe Acne

All characteristics of moderate acne plus cysts, widespread lesions (upper back/chest), high scarring risk.

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Acne Referral Triggers

Moderate or severe acne, treatment failure, acne outside of typical age range, suspected drug-induced acne, occupational causes, or suspected rosacea.

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Acne Affected Areas

Face, neck, chest, back, and shoulders (high sebaceous gland areas).

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Rosacea vs. Acne

Rosacea causes facial flushing, papules/pustules, but no comedones. Typically affects adults over 40, more in women.

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Acne-related Occupational Risks

Long-term contact with oils can be a risk factor.

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Treatment Failure Referral

If mild acne treatment fails within 8 weeks, refer to a doctor.

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Benzoyl peroxide use

A first-line OTC treatment for acne, available in different strengths (gels, lotions, creams).

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Benzoyl peroxide side effects

Possible initial skin reddening, soreness, stinging, drying, and peeling. Can bleach fabrics.

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Benzoyl peroxide application

Apply to the entire affected area, after cleansing, to prevent new acne lesions.

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Adapalene treatment

A retinoid, first-choice acne drug with similar efficacy to other retinoids but fewer side effects.

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Acne skin cleansing

Gentle washing with mild soap before applying acne treatments can reduce skin oil.

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Retinoids for acne

Family of effective acne drugs, that help unclog pores and stimulate skin cell turnover.

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Acne drug progression

Begin with lowest strength benzoyl peroxide and gradually increase if needed.

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Skin irritation from acne treatments

Redness, soreness, and other irritation are common early side effects and should be expected.

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OTC Acne Treatment

Differin Gel 0.1% is the first retinoid available over-the-counter for acne in patients 12 years and older.

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Adapalene & Sun

Adapalene is a photoirritant, so sun avoidance and sunscreen are crucial while using it.

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Diet and Acne

There's no evidence linking diet (like chocolate or fatty foods) to acne.

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Acne Treatment Time

Treating acne takes time, up to 6 months for maximum benefit, so persistence is key.

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Skin Hygiene and Acne

Acne isn't caused by poor hygiene, but regular washing with soap and water or antibacterial products can help.

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Hydrocortisone & Acne

Topical hydrocortisone is not recommended for acne, as it can worsen the condition.

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Makeup and Acne

Heavy, greasy makeup can make acne worse, opt for water-based makeup and remove it thoroughly.

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Scabies

Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei, leading to intense itching.

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Scabies Mite Lifespan

The scabies mite can only survive for approximately one day outside of its human host.

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Scabies Transmission

Scabies is primarily transmitted through direct, close personal contact with an infected individual.

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Scabies Reinfestation Prevention

To prevent reinfestation, wash bedclothes and clothing at a minimum temperature of 50°C after treatment.

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First-line Treatment for Scabies

Permethrin cream is the recommended first-line treatment for scabies.

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Treating Scabies Itch

For residual itching after scabies treatment, a systemic antihistamine is recommended, along with optional calamine lotion or crotamiton cream.

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Benzoyl Peroxide Action

Benzoyl peroxide works as an antibacterial and anticomedogenic agent, primarily used for acne treatment.

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Benzoyl Peroxide Application Frequency

Benzoyl peroxide application frequency can be increased from once daily to twice daily after a week, and a higher strength preparation may be tried after 2-3 weeks.

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Benzoyl Peroxide Usage Duration

For effective acne treatment, benzoyl peroxide typically requires 6-8 weeks of consistent use.

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Study Notes

Eczema/Dermatitis

  • Dermatitis and eczema are used interchangeably to describe skin conditions with dryness, redness, itching, and sometimes weeping or crusting.
  • Dermatitis is more often used when an external trigger exists (as in contact dermatitis), while eczema usually refers to endogenous causes in individuals (like atopic eczema)
  • Contact dermatitis is categorized into irritant and allergic types.

Irritant Contact Dermatitis (ICD)

  • ICD is the most common type of contact dermatitis.
  • It is caused by direct exposure to a substance that irritates the skin.
  • This can happen with initial or repeated exposures; the substance could be strong or mild.
  • Occupational exposures to water or irritant substances are common causes.

Allergic Contact Dermatitis (ACD)

  • ACD is caused by a hypersensitivity reaction to a sensitizing agent.
  • Irritants commonly include water, detergents, solvents, and certain metals (like nickel or chromate).
  • ACD often leads to an immunologic reaction.
  • Allergens can include metals, rubber, dyes, certain plants and medications.

Contact Dermatitis Patient Assessment

  • Work-related exposure: Assess job/hobbies, onset and resolution of the rash, whether symptoms improve when away from work to determine if work is the cause.
  • Duration of rash: Rash lasting more than two weeks requires referral to a doctor.

Severity and Referral

  • Severe symptoms (fissured/bleeding/infection) require doctor referral
  • Failed medication, signs of infection or duration of more than 2 weeks necessitate referral.

Treatment

  • Emollients: Regularly used to soothe, hydrate, and provide a protective layer to the skin.
  • Topical steroids: Mild to moderate topical steroid creams or ointments are first-line treatments; their use depends on the severity. Hydrocortisone is a mildly potent OTC option, while clobetasone is moderately potent, but not always available as an ointment.
  • Other treatments: Antipruritics (e.g., calamine, crotamiton) or topical anesthetics (e.g., benzocaine) can be used, though not recommended for prolonged use due to potential for sensitization.

Acne

  • Acne, also known as acne vulgaris, commonly affects young people.
  • It results from a combination of factors, with hormonal changes during puberty often playing a role.
  • Lesions range from non-inflammatory (comedones - blackheads, whiteheads) to inflammatory (papules, pustules, nodules, cysts).
  • Acne can be mild, moderate, or severe based on lesion type and distribution.

Acne assessment

  • Age: Acne is rare in infants and young children, thus referral may be necessary.
  • Duration: Persistent acne outside the typical teenage years, or after previous treatments have failed, needs assessment.
  • Occupation: Long-term contact with oils (in some cases) may lead to specific acne treatment plans.
  • Medications: Certain medications (e.g., steroids, lithium, contraceptives) are linked to acne-like skin reactions.

Scabies

  • Scabies is a contagious skin infestation caused by the mite Sarcoptes scabiei.
  • The primary symptom is intense itching, especially at night.
  • Affected areas commonly include skin folds and extremities.
  • Scabies may affect all ages and is common in vulnerable communities.

Scabies Assessment and Treatment

  • Symptom duration: Severe itching may persist even after successful treatment.
  • History of infection: Exposure to other infected people.
  • Physical examination: Presence of burrows as well as signs of infection (from scratching).
  • Treatment Protocol: (Generally) 7-day spaced applications of medication.

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Skin Conditions Lecture 9 PDF (2020-2021)

Description

This quiz covers the key concepts of eczema and dermatitis, including their definitions and differences. It explores irritant and allergic contact dermatitis, their causes, and reactions. Test your understanding of these common skin conditions and the factors that contribute to them.

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