The document discusses eczema and urticaria. It defines eczema and outlines its aetiology, pathogenesis, clinical features, and types. It also introduces urticaria, discusses its pathophysiology and classification. The document describes the aetiology, clinical features, and diagnosis of urticaria. Its objectives are to explain these topics regarding eczema and urticaria.

1. Eczema &Urticaria
Dr Akshay Shetty
Asst. Professor
SSRAMCH Inchal

2. Eczema (Atopic Dermatitis)
This Photo by Unknown Author is licensed under CC BY

3. Contents
• Objectives
• Definition of Eczema
• Aetiology of Eczema
• Pathogenesis of Eczema
• Clinical features of Eczema
• Types of Eczema
• Introduction of Urticaria
• Pathophysiology of Urticaria
• Classification of Urticaria
• Aetiology of Urticaria
• Clinical features of Urticaria
• Diagnosis of Urticaria
• Summary
• References
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4. Objectives
By the end of the presentation the students must be able
To know the Definition of Eczema
To know the Aetiology of Eczema
To know the Pathogenesis of Eczema
To know the Clinical features of Eczema
To know the Types of Eczema
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5. Contd…
To know the Introduction of Urticaria
To know the Pathophysiology of Urticaria
To know the Classification of Urticaria
To know the Aetiology of Urticaria
To know the Clinical features of Urticaria
To know the Diagnosis of Urticaria
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6. Definition
From the Greek: ‘to boil over’
• Pruritic papulovesicular dermatitis characterised by
erythema, oedema and a serous exudate in the epidermis,
an inflammatory infiltrate in the dermis, oozing and
vesiculation, and crusting and scaling; and later by
lichenification, thickening, signs of excoriations and altered
pigmentation.
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7. Aetiology of Eczema
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8. Pathogenesis of Eczema
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9. Clinical features of Eczema
Major features:
• Pruritis
• Rash
• Face and extensors in infants
• Flexural in older children
• Chronic or chronically relapsing
• Personal or family history of other atopic disease
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10. Contd..
Other common features:
• Dryness
• Dennie-Morgan folds
• Allergic shiners
• Facial pallor
• Pityriasis alba
• Keratosis pilaris
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11. Contd..
• Icthyosis vulgaris
• White dermatographism
• Conjunctivitis
• Keratoconus and cataracts
• Elevated serum IgE
• Skin prick test positivity
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12. Types
• Eczema / atopic dermatitis
• Seborrhoeic dermatitis
• Discoid, nummular eczema
• Dyshidrotic eczema / pompholyx
• Contact dermatitis
• Varicose eczema
• Asteatotic eczema
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18. This Photo by Unknown Author is licensed under CC BY-SA-NC

19. Introduction to Urticaria
• Affects 20% of population
• Occurs across the age spectrum
• Sometimes possible to identify a trigger such as food, drug, insect sting or
infection
• More than 2/3 of cases are self-limiting
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20. Pathophysiology
• Reaction mediated by activated mast cells and basophils in superficial dermis
• When activated, mast cells release histamine causing itching and vasodilators
which cause swelling
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21. Urticaria
Acute episodes < 6
weeks
more likely to have an
identifiable trigger
Chronic episodes last >
6 weeks
less likely to have an
identifiable trigger
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22. Aetiology of Urticaria
• Acute Urticaria
• Foods/food products most commonly milk, egg, peanut, wheat and soy in kids
• Tree nuts, peanuts and shellfish in adults
• Yellow food dye annatto
• Red food dye carmine
• Contact with raw fruits or vegetables, animal saliva, certain detergents or
perfumes
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23. Contd…
• Viral or bacterial infection especially in children
• Parasitic infections usually in combination with impressive eosinophilia
• Medications especially antibiotics
• Stinging insects including bees, wasps, hornets, imported fire ants
• Latex products
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24. Clinical features of Urticaria
• Pruritic (most severely at night)
• Erythematous
• Often exhibit central pallor
• Blanches
• Oval, round or irregular shape or plaques
• Plaques “move” to different locations over minutes to hours
• Last less than 24 hours
• Leave no residual marks (other than those created by scratching)
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25. Diagnosis of Urticaria
• Detailed history
• including has pt ever had urticaria before
• were there any unusual exposures immediately prior to the episode
• Does the patient have pictures?
• Physical Exam
• If the patient does not have lesions at time of exam, consider showing them
photos of urticaria as an example
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26. Contd….
• Laboratory testing
• Allergy testing if specific trigger can be implicated (would possibly include skin
prick testing or immunocap testing for IgE to specific food or drug)
• CBC
• ESR
• AEC
• LFT
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27. Summary
Pathophysiology of Urticaria
Classification of Urticaria
Aetiology of Urticaria
Clinical features of Eczema
Types of Eczema
Definition of Eczema Aetiology of Eczema
Introduction of
Urticaria
Pathogenesis of
Eczema
Clinical features of
Urticaria
Diagnosis of Urticaria
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28. References
• Davidson Principles Of Medicine & Practice Of Medicine .20th Ed.
• Harrison’s PRINCIPLES OF INTERNAL MEDICINE Seventeenth Edition
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29. This Photo by Unknown Author is licensed under CC BY
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