ECZEMA

(Dermatitis)
Supervised by : Dr Lim Jo Anne

Presenters : Sophia Cheah Shook Leng

: Ariff Najmi Asari
Eczema

A collective term referring to non-infectious inflammations of the skin

Symptoms such as redness, blistering, nodules and crusting may occur on the skin.

Classified based on :

1. Types - Constitutional / Endogenous, Contact / Exogenous

2. Duration - Acute, Subacute and Chronic
Atopic Dermatitis (most common)
Inflammatory skin disease with no known single cause (inherited barrier defect - filaggrin deficiency &
immune system dysfunction - high Th-2 cells)

Common in children (80% develop before 6 years old)

RFs : Family history allergic conjunctivitis, allergic rhinitis, eczema and asthma

CFs : Dry skin, severe pruritus (itchiness), cutaneous hyperreactivity

Contact Dermatitis
Skin inflammation arising from direct skin exposure to substance (irritant) and/ or environmental factors that
causes irritation to the skin.

Can be allergic (allergen induces an immune response- delayed hypersensitivity reaction) or irritant-induced
(substance directly irritates the skin)

RFs : Young children, elderly, personal history of atopic dermatitis, exposure to certain occupational substance

CFs : [ACD] well- demarcated, intensely pruritic, eczematous eruption localised to area of skin in contact

[ICD] Acute - erythema, oedema, vesicles, bullae & Chronic - lichenification, hyperkeratosis, fissuring
Asteatotic Dermatitis

Pruritic dermatitis with dry skin that occurs at lower extremities d/t water loss from stratum corneum when
skin barrier breaks down

Common in elderly and at the upper & lower limbs

RFs : Low environmental humidity (cold & dry)

CFs : Diamond-shaped, scaling and superficial fissuring

of the skin with

varying degree of inflammation & hemorrhage

(severe), pruritus
Nummular / Discoid Dermatitis
Chronic, relapsing inflammatory skin disease with unknown cause (however a/w Staphylococcus aureus)

RFs : Chronic alcoholism, certain drug usage

CFs : Multiple pruritic, coin-shaped, eczematous lesions

Seborrheic Dermatitis
A sebaceous gland centred skin inflammation.

An inflammatory response to Malassezia yeasts.

RFs : Male, oily skin type, family history, immunocompromised patients (HIV- severe)

CFs : Erythematous, scaly patches located in areas with high density of

sebaceous glands (eg: scalp, eyebrows, nasolabial folds)

Gravitational / Stasis Dermatitis
Skin inflammation of the lower extremities occurring in patient with chronic venous insufficiency d/t
activation of innate immune response when fluids collect in the tissues

RFs : > 70 y.o, history of DVT / cellulitis, chronic swelling of lower legs, varicose vein

CFs : Erythematous, scaling, and eczematous

patches / plaques on oedematous legs

Dyshidrotic / Vesicular / Pompholyx Dermatitis
Intensely pruritic, chronic and recurrent vesicular dermatitis of unknown aetiology that involves young adults
(usually bilateral - fingers, palm and soles)

CFs : Multiple small, deep-seated vesicles (may coalesce to form bullae & may be superinfected)
Investigations & Managements
Investigations

Generally, investigations are not needed unless it’s to confirm a diagnosis or needed to rule out some conditions.

Biopsy can be taken if it is needed to confirm and identify causative agents

Treatments (Short-term Management)

1. Topical steroids (Doses depends on severity of condition)

2. Steroid sparing agents (If requires a longer period of steroid usage)
3. Antibiotics - Topicals (Creams) - localised condition & Systemic (Orally / IV) - severe condition

Maintenance (Long-term Management)

*Goal : To maintain natural skin barrier

1. Moisturiser
2. Mild Cleanser
3. Avoid / remove triggers / causative agents
KAHOOT SESSION
THANK YOU
Any questions ?