Atopic & Contact Dermatitis; Scaly Dermatoses

Spring Term 2006

Lab Week 3

Dry Skin

Most common cause of pruritis Windy, cold, arid environment S&S: roughness, scaling, loss of flexibility, fissures,

inflammation, pruritis, platelike scaling, cracked appearance

Location: mostly arms and legs Risk of secondary infection Tx: modify bathing, use emollients, humectants,

keratin softeners, HC, antipruritics

Atopic Dermatitis

Acute, subacute, or chronic Atopic triad: asthma, allergic rhinitis, AD Exacerbating factors Family history < 1 year of age: redness, chapping on cheeks Primary symptoms: intense pruritis, papules and vesicles Symmetric lesions, flexor surfaces Scratching, lichenification excoriation See PCP if signs of bacterial/viral infection pustules, vesicles,

crusting Tx: avoid triggers, use emollients, HC, astringents, antipruritics

Atopic Dermatitis

Scaly Dermatoses: Dandruff

Chronic, non-inflammatory, diffuse Scalp condition Fine, excessive scaling Pruritis is common Pityrosporum ovale Tx: use cytostatic and keratolytic agents,

ketoconazole

Scaly Dermatoses: Seborrhea

Subacute or chronic, inflammatory Location: scalp, face, trunk, hairy areas S&S: erythematous, scaly, pruritic rash or dull,

yellowish, red lesions; well demarcated, oily; exudation, thick crusting

Patches or plaques Improves in warmer seasons, exacerbated in cold

months Tx: Use HC, cytostatic and keratolytic agents,

ketoconazole

Scaly Dermatoses: Seborrhea

Scaly Dermatoses: Psoriasis

Noncontagious, chronic, inflammatory Type I & II; plaque, inverse, guttate Triggers (p.834) S&S: Symmetrical, well circumscribed, sharply demarcated, light

pink to bright red or maroon, overlaying plaque, thick white scales (pulled off in layers), ~pruritis; Auspitz signs

Lesions start as small papules, grow and unite to form plaque Locations: extensor surface of elbows, knees, lumbar region,

scalp, posterior auricular area…. Nail and joint involvement Tx: Use emollients, HC, cytostatic and keratolytic agents

Scaly Dermatoses: Psoriasis

Scaly Dermatoses: Psoriasis

Contact Dermatitis: Irritant

Exposure to harsh chemicals, solvents S&S: Rash: inflamed, swollen, red,

developing vesicles or papules; may ooze ulcer formation, localized necrotic areas

Itching, stinging, burning Locations: face, dorsal surface of hands and

arms Tx: Use astringents, HC,

antipruritics/anesthetics

Contact Dermatitis: Allergic

Allergen exposure. Most common: poison oak/ivy/sumac

Metal or cosmetic allergy 24-48 hours to develop (Type IV hypersensitivity

reaction) S&S: depends on allergen, site, duration of

exposure; typically red, swollen w/ blisters; itching, burning, pain

Tx: Use astringents, HC, antipruritics/anesthetics

Contact Dermatitis: Allergic

Contact Dermatitis: Allergic