2 D. MOIST/OOZING ECZEMATOUS DERMATITIS LESION ATOPIC DERMATITIS 1.) Moist plaques with crust 2.
) Multiple intensely pruritic erythematous plaques with scaling and excoriations 3.) Erythematous lichenification with accentuation of skin margins AGE OF PREDILECTION 2mo 1y/o AREA OF PREDILECTION Nape, antecubitals and popliteal fossa HALLMARK Dennie Morgan Fold Hertoghes sign Headlight sign Tache blanche ETIOLOGY Associated with immunological imbalance; Significantly increased Ig E PREDISPOSING FACTORS TREATMENT Temporarily improved with topical steroids OTHER INFO Appeared on the area where diclofenac gel was applied Diagnostic criteria has been modified for young children and this includes: pruritus, typical facial or extensor dermatitis, history of atopic disease Dry Infantile Atopic Dermatitis associated with xerosis (dry skin), keratosis pilaris May also complain of falling hair
SEBORRHEIC DERMATITIS
1.) No to mild itching; moist plaques with chronic, superficial, inflammatory disease of the skin
Glabella, nasolabial folds, scalp
Pityosporum ovale
Topical antifungals
LESION 2.) Scanty, loose, moist scales and crust 3.) Recurrent slightly erytematous patches and plaques with oily-looking scales 4.) Dry loose whitish/yellowish scales Discrete, round, wellcircumscribed or coin-shaped erythematous edematous, vesicular and crusted patches
AGE OF PREDILECTION
AREA OF PREDILECTION
HALLMARK
ETIOLOGY
PREDISPOSING FACTORS
TREATMENT
OTHER INFO
NUMMULAR ECZEMA
Young adulthood and old age
INFECTIOUS Pruritic, vesicular, pustular, ECZEMATOUS / or crusted dry and scaly AUTOSENSITIZATION eruptions DERMATITIS
Regional clusters of lesions (eg. Legs or trunk) or generalized, scattered, Lower legs (older men), trunks, hands, and fingers (younger females) Develops on area macerated by the discharge from an infected ulcer or sinus
Unknown
Triamcinolone Crude coal tar (refractory) PUVA or UVB 311nm therapy
Recurrent Staphylococcal infection often present
Skin becomes sensitized to bacterial or tissue chemical substances
Diabetics with nonhealing wounds Chronic otitis media, bedsore, fistula; eye, nose, vagina discharge
Oral glucocorticoids
Do antibiotic sensitivity testing to treat underlying cause
LESION CONTACT DERMATITIS A. IRRITANT CONTACT DERMATITIS ACUTE. Erythema with a dull nonglistening surfacevesiculation (or blister formation)erosioncrustin gshedding of crusts and scaling or erythema (chemical burn)necrosisshedding of necrotic tissueulcerationhealing CHRONIC. Drynesschappingerythe mahyperkeratosis and scalingfissures and crusting. Sharp margination gives way to ill-defined borders, lichenification. In irritant reaction ICD also vesicles, pustules, and erosions. Erythematous papules, vesicles, and linear and symmetrical lesions within scratch marks
AGE OF PREDILECTION
AREA OF PREDILECTION Hands
HALLMARK
ETIOLOGY ACUTE. Direct cytotoxic damage to keratinocytes
PREDISPOSING FACTORS
TREATMENT Topical steroids (Betamethasone dipropionate, Clobetasol proprionate)
OTHER INFO Non-allergic inflammatory response No previous exposure necessary
[Link] damage to cell membranes protein denaturation and cellular toxicity
B.
ALLERGIC CONTACT DERMATITIS / DERMATITIS VENENATA
Delayed reaction; cellmediated hypersensitivit y reaction
Topical steroids
With previous sensitization Rubbers, cosmetics, dyes, oil resins, chemicals in fabrics, insecticides, resins, products of bacteria, fungi, parasites 3
LESION C. DIAPER/NAP KIN DERMATITIS Erythematous and papulovesicular dermatitis Superficial erosion in severe cases Tip of penis maybe irritated and crusted
AGE OF PREDILECTION
AREA OF PREDILECTION Lower abdomen, genitals, thighs,convex surfaces of the buttocks
HALLMARK Inguinal and suprapubic folds not involved
ETIOLOGY Alkaline irritative effects of ammonia formed in the wet diaper by the splitting of urea by the ammoniaforming bacillus in the feces
PREDISPOSING FACTORS
TREATMENT Frequent change of diapers Topical Hydrocortisone
OTHER INFO
D.
IRRITANT HAND DERMATITIS /HOUSEWIF ES ECZEMA
Begins with dryness and redness of the fingers Dry scales with peeling are evident at the tips of the fingers, chapping is seen on the back of the hands, and erythematous hardening of the palms and fissures develops. Pruritic, tender Plaque / patch / maceration /erosion erythema
Under rings when not removed while washing
Betamethasone diproprionate Clobetasol proprionate Triamcinolone
INTERTRIGO
Inframammar y regions, axillae, groins, gluteal folds, where skin surfaces are in apposition
Inflammatory reaction caused by friction, heat, moisture
LESION STASIS ECZEMA Blotchy red mottling with yellowish or light brown pigmentation of the Maybe papular, scaly and itching Pruritic erruptionlichenification thick plaques
AGE OF PREDILECTION
AREA OF PREDILECTION lower inner 1/3 of the legs
HALLMARK
ETIOLOGY Chronic Venous Insufficiency
PREDISPOSING FACTORS
TREATMENT
OTHER INFO Swelling maybe noted late in the afternoon and spontaneously relieved in the morning
PHOTOALLERGIC DERMATITIS
Neck, face, forearms, dorsum of hands and sun-exposed areas
2 E. DRY CHRONIC ECZEMA LESION LICHEN SIMPLEX CHRONICUS (NEURODERMATITIS CIRCUMSCRIPTA) Leathery skin patches are excoriated, slightly scaly or moist, and rarely nodular Thickened hyperpigmented plaques with prominent skin markings secondary to constant scratching AGE OF PREDILECTION AREA OF PREDILECTION Nuchal area (female), scalp, ankle, lower legs, upper thighs, exterior forearms, vulva, pubis, anal area, scrotum, groin HALLMARK ETIOLOGY Epidermal hyperplasia Stress and anxiety PREDISPOSING FACTORS TREATMENT Topical steroids Goal: cessation of pruritus OTHER INFO There is a habitual itch-scratch cycle
LESION PRURIGO NODULARIS single or multiple itching nodules with excoriations individual lesions are pea-sized or larger, firm, erythematous, and brownish Uniform time of the primary lesion (dome-shaped papules topped by a vesicle) and by chronicity, severity, scars, lichenification, and eczematization
AGE OF PREDILECTION
AREA OF PREDILECTION Anterior surfaces of thighs and legs
HALLMARK
ETIOLOGY Constant picking and scratching
PREDISPOSING FACTORS
TREATMENT Triamcinolone
OTHER INFO
PRURIGO MITIS
Early childhood
Topical steroids
Symmetricallydistributed
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