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?

Dermatitis requires an external precipitating factor. Signup and view all the answers

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

A rash that has been present for more than 2 weeks. Signup and view all the answers

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

Diaper area Signup and view all the answers

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

10 years Signup and view all the answers

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

Allergic contact dermatitis Signup and view all the answers

For how long can hydrocortisone be used in Canada?

2 weeks Signup and view all the answers

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

Signs of bacterial infection, such as weeping. Signup and view all the answers

What type of skin should hydrocortisone not be applied to?

Facial skin Signup and view all the answers

How often can hydrocortisone cream be applied per day?

2 to 4 times Signup and view all the answers

What is a fingertip unit used for?

Measuring cream application area Signup and view all the answers

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

Benzocaine Signup and view all the answers

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

It has no effect on protein synthesis Signup and view all the answers

Is the use of hydrocortisone during pregnancy considered safe?

Yes, it is OK Signup and view all the answers

What characterizes mild acne?

Predominantly open and closed comedones with few inflammatory lesions Signup and view all the answers

When should a patient with moderate acne be referred?

If lesions are painful and widespread Signup and view all the answers

What additional condition is indicative of severe acne?

Development of cysts Signup and view all the answers

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

Acne beginning outside the normal age range Signup and view all the answers

What is NOT a characteristic of rosacea?

Presence of comedones Signup and view all the answers

Which medication is frequently associated with acne-like lesions?

Topical steroids Signup and view all the answers

Which of these conditions requires referral to a doctor?

Patient with mild acne not responding after 8 weeks Signup and view all the answers

What is a potential cause of occupational acne?

Long-term contact with oils Signup and view all the answers

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

To prevent new lesions from forming Signup and view all the answers

Which concentration of benzoyl peroxide is recommended to start treatment?

2.5% Signup and view all the answers

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

Gels Signup and view all the answers

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

It may lead to skin reddening and soreness Signup and view all the answers

How should benzoyl peroxide be applied to be most effective?

Over the entire affected area Signup and view all the answers

What adverse effect can occur with sensitization to benzoyl peroxide?

Redness and inflammation of the skin Signup and view all the answers

Which statement about retinoids in acne treatment is accurate?

They stimulate epithelial cell turnover Signup and view all the answers

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

It may lead to discoloration or bleaching Signup and view all the answers

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

0.1% Signup and view all the answers

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

Sun avoidance and sunscreen use Signup and view all the answers

Which statement regarding diet and acne is accurate?

There is no evidence linking diet with acne. Signup and view all the answers

What is recommended to ensure maximum benefit from acne treatments?

Continuous treatment for up to 6 months may be required. Signup and view all the answers

What is a common misconception about acne and skin hygiene?

Acne is caused by poor hygiene. Signup and view all the answers

Why is the use of topical hydrocortisone contraindicated in acne?

It potentiates the effects of androgenic hormones. Signup and view all the answers

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

Water-based foundations Signup and view all the answers

Which demographic is primarily affected by scabies?

Poor communities Signup and view all the answers

What is the primary method of scabies transmission?

Close personal contact Signup and view all the answers

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

Around 1 day Signup and view all the answers

What is the first choice treatment for eradicating scabies infection?

Permethrin cream Signup and view all the answers

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

Washing bedclothes at a minimum temperature of 50◦C 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?

Consult a physician Signup and view all the answers

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

6–8 weeks Signup and view all the answers

Which action should be avoided when using benzoyl peroxide?

Minimal contact with eyes and mucous membranes Signup and view all the answers

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

To use white sheets and pillowcases Signup and view all the answers

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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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.