Dermatitis & Eczema Presentation PDF

Dermatitis Dr. Abdulrahman Omar ABHS, Dermatology 5th grade – College of medicine University of Duhok Objectives: Understand the Pathogenesis and Causes of Eczema Get Familiar with the Different Types of Eczema and Their Manifestations Understand the management strate...

Dermatitis Dr. Abdulrahman Omar ABHS, Dermatology 5th grade – College of medicine University of Duhok Objectives: Understand the Pathogenesis and Causes of Eczema Get Familiar with the Different Types of Eczema and Their Manifestations Understand the management strategy for patients with eczema Terminology: ECZEMA=DERMATITIS Dermatitis = Dermat + itis refers to skin means “inflamed” (thus, inflamed skin) Greek- meaning – (ec-) over – (-ze) out – (-ma) boiling  Eczema: A Working Classification Exogenous (Irritant contact dermatitis and Allergic contact dermatitis) Endogenous (Atopic dermatitis and Seborrheic dermatitis) Morphology  Stages of Eczema Acute : erythema, edema, oozing and papulovesicular erruption  In the sub-acute eczema the lesion shows less erythema, edema and oozing with scaling and crusting. In the chronic eczema the lesion shows dryness and thickening (lichenification).  Atopic Dermatitis Multifactorial :  Genetic Factors  Impaired Epidermal Barrier : Decreased Filaggrin protein  Environmental factors  Immune Dysregulation : TH1-TH2 Imbalance The Atopic Triad Aggravating factors  AD stages Infantile 2 months to 2 years Childhood 2 years to 10 years Adult adolescence to adulthood  Management STEP 1: Complete Emollient therapy and Education STEP 2: Identification & avoidance of allergens triggers STEP 3: Treatment of flare with topical corticosteroids / calcineurin inhibitors  Seborrheic dermatitis Mainly affecting hairy areas, often showing characteristic greasy yellowish scales , interscapular areas and Intertriginous lesions of the armpits, umbilicus. On The Face typically involve the inner thirds of the eyebrows and NLF Etiology : Pityrosporum ovale (Malassezia furfur) Sebaceous gland activity Seen more commonly in Parkinson and HIV patients.  Treatment Mild-Moderate topical steroids Shampoo : Tar, 2% selenium sulfide, Ketoconazole , Ciclopirox olamine, Pyrithione zinc. Topical Antifungal : Cotrimazole , Micanazol cream. Systemic Antifungal Medications in sever cases: Itraconazole , Fluconazole.  Types of exogenous eczema Irritant Contact Dermatitis An inflammatory reaction in the skin resulting from exposure to a substance that causes an eruption in most people who come in contact with it, which is localized to the exposure area Allergic Contact Dermatitis An acquired delayed sensitivity to various substances that produce inflammatory reactions in only those who have been previously sensitized to the allergen, which i localized or involving an extensive area of the body ICD ACD ICD Pathogenesis : Direct cytotoxic effects ACD Pathogenesis : its type 4 hypersensitivity reaction Nickle dermatitis  Treatment Avoidance Restore Skin Barrier. Anti inflammatory medications.