Eczema: Allergic Skin Diseases PDF

Eczema DR/ Maha Kandil Prof. oF Dermatology Faculty Of Medicine- Minia University Dermatitis / Eczema O Dermatitis = inflammation of the skin. O There are many etiologies and a wide range of clinical findings. O Characterized by 3 clinical stages: - Acute...

Eczema DR/ Maha Kandil Prof. oF Dermatology Faculty Of Medicine- Minia University Dermatitis / Eczema O Dermatitis = inflammation of the skin. O There are many etiologies and a wide range of clinical findings. O Characterized by 3 clinical stages: - Acute - Subacute - Chronic Acute Eczema: characterized by: - Itching - Redness - Papulovesicular eruption. Subacute Eczema:characterized by: - Itching - Scaling - Crustations. Chronic Eczema:characterized by: - Itching - Lichenification (Thickened hyperpigmented skin. (Exaggeration of skin markings).  Acute Eczema Subacute Eczema Chronic Eczema  Management of Eczema O The basic role is to: dry the wet lesion and soften the dry one. O Topical treatment. O Systemic treatment. Acute Eczema (WET): Local Treatment : - Drying antiseptic solutions: potassium permanganate. - Local corticosteroids: moderate potency; in cream or lotion form with or without antibiotic cream (for 2ry infection). Systemic Treatment : - Antihistamines - Broad spectrum antibiotics (for 2ry infection). - Systemic steroids in generalized and severe forms. Chronic Eczema (DRY) : Local Treatment - Emollients e.g. Vaseline. - Local corticosteroids: moderate to high potency; in ointment form. - Systemic Treatment - Antihistamines. - Systemic steroids in generalized and severe forms. O Atopic dermatitis OContact dermatitis O Seborrhoeic dermatitis O Nummular eczema O Asteatotic eczema O Dyshydrotic eczema (pompholyx) O Stasis dermatitis O Lichen Simplex Chronicus (LSCh) O Infective dermatitis O Pityriasis alba Contact Dermatitis (CD) Definition: O Dermatitis precipitated by an exogenous agent, often a chemical. Classification: O Allergic Contact Dermatitis (ACD) O Irritant Contact Dermatitis (ICD)  Allergic Contact Dermatitis (ACD) (Sensitization Dermatitis) Definition: O Immunological reaction that develops in genetically susceptible individuals after exposure to the allergen (i.e. sensitizer). O These sensitizers do not usually cause skin changes on first exposure but may produce the eczematous reaction after repeated exposure. Common Sensitizers (Allergens): O Chemicals: Dyes, nickel, cement, detergents.… O Cosmetics: Lipstick, nail polish, hair dyes, eyeliners, depilators…. O Topical drugs: Sulfonamides, penicillin ointment and local antihistamines. O Textiles: Nylon, wool… O Clinical Picture: O Acute and chronic lesions are well demarcated and localized to the site of contact with the allergen. O The development of disseminated eczema may occur. Diagnosis: O Patch Testing: remains the gold standard for accurate and consistent diagnosis.  Irritant Contact Dermatitis (ICD) Definition: O It is a localized non-immunologically cutaneous reaction. O Affects any individual. O ICD results from a the direct cytotoxic effect due to single or repeated application of a chemical substance to skin. -- ICD is related to exposure parameters such as concentration, pH, temperature, occlusion, repetitiveness, and duration of contact. -- Strong irritants such as strong acids and alkalis, in severe cases, cause necrosis and ulceration, which is termed chemical burn.  Treatment of CD PROPHYLACTIC : Avoiding etiologic agents. Protective measures: using occlusive gloves with underneath cotton gloves to absorb perspiration. Curative: According to stage ; acute, subacute or chronic