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Dermatology
Random Derm stuff
8
Medical
Professional
09/07/2014

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Term
Id Reaction
Definition
autoeczematization ractions. A secondary dermatitic eruption from a primary (often inflammatory) skin disorder. Commonly from eczema, dermatophyte infection, or stasis dermatitis.
Display pruritic, papulovesicular eruption distant from primary site.
tx by treating underlying disease.
Term
Acute Eczematous Inflammation Treatment
3 kinds
Definition
Wet compresses w/ or w/o bowens solution
Oral prednisone 20 mg BID x 7-14 days. May need 30 mg BID for first couple days. No need to taper w/ this short a course
Oral Keflex or dicloxacin. Keflex 500 mg BID x 7days. Only use if signs of superficial infx like pustules, purulence or crusts.
Term
asteototic eczema
Definition
presents as subactue eczematous inflammation.
Pruritic, dry, scaly, and fissured skin. Common on shins in the elderly possibly d/t a/w leg edema. Can crack enough to bleed.
4 types

Asteatotic eczema of the lower extremities in elderly persons secondary to aging, dehydrated skin, and malnutrition
Cracked erythema secondary to irritant contact dermatitis from soaps or detergents
Eczema craquelé in areas in which corticosteroid therapy was discontinued
Asteatotic eczema in neurologic disorders
Term
Treatment options for subacute eczematous inflammation
Definition
topical steroids (group III through V). If V, may use occlusion. III can be applied up to 4 times daily no longer than 2 weeks. Prefer ointments if it is very dry. Traimcinoloneacetonide 0.1% w/ occlusion is cheap and yields fast effective results.
Topical tacrolimus > pimecrolimus. often need to initiate topical steroids for rapid control until tacrolimus begins to work.
Topical doxepin 5% (zonalon) is good for pruritis. SE's include stinging and drowsiness. Only for >12yo.
Lubrication is vital!!! continue for 2-3 weeks post sxs resolution.
Mild soaps (dove, cetaphil, basis) recommended use sparingly.
Topical tar for steroid resistant cases.
Term
keratolysis exfoliativa
Definition
chronic, asymptomatic, non-inflammatory and bilateral peeling of palms and occasionaly soles. Unknown cause. often a/w sweaty palms/soles. Starts centrally and spreads peripherally. Seemingly from a ruptured vesicle although it is never seen. Benign condition disappears in 1-3 weeks. Tx w/ moisturizers.
Term
Hyperkeratotic eczema
Definition
very thick chronic eczema of palms and occasionally soles. Exclusively in men. Forms yellow-brown dense scale forming deep interconnected cracks. similar to "drying mud in a river bed". moist beneath and not easily removed w/ scalpel blade. May be d/t allergy or irritant although not always. Tx like chronic eczema.
If recurrent, consider patch testing.
Term
chronic eczema appearance and treatment
Definition
inflamed areas thicken and cause surface skin marking to be prominent. Thick plaques cause "washboarding" of skin. The borders are well defined but not as sharply as psoriasis. MC in areas of easy reach from habitual scratching. Pts can scratch unconsciously and while sleeping.
Tx - resistant and require potent steroids. Groups II-V w/ occlusion at night for 1-3 weeks. Group 1 w/o occlusion. Clobetasol foam is effective.
Tacrolimus 0.1% is alternative.
Intralesional injections w/ kenalog 10 mg/mL is very effective. Use 27-30 gauge needle and infiltrate until entire lesion blanches white. can give additional injections at 3-4 weeks intervals.
Term
Dyshidrosis
aka what?
findings, etiologies, and treatment?
Definition
aka pompholyx
distinctive symmetric vesicular hand/food dermatitis. Moderate to severe inching precedes vesicle appearance on palms and sides of fingers. palms can be red and wet (hence dyshidrosis). Vesicles slowly resolve over 3-4 weeks and are replaced by rings of scale. Chronic eczematous changes may follow. Pain rather than itching is chif complain. Differentiat from psoiais via speed of spontaneous resolution and delay in formation of pustular vesicular fluid.
Etiology - MC cause is mycosis followed by allergic (cosmetic/hygeine products, metals) or idiopathic in atopics. Ingestions of allergens can cause it.
Tx - topical steroids, col compresses. Short oral steroids for acute flares. Responds to PUVA.
Severe non responsive cases may need low dose MTX (15-22.5 mg/week)
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