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eczema.pptx
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- 2. “All eczemas aredermatitis, but not all dermatitis are eczemas.”
- 3. Classification Exogenous eczemas ▪ Irritantdermatitis ▪ Allergic contact dermatitis ▪ Photodermatitis ▪ phytodermatitis Endogenous eczemas ▪ Atopic dermatitis ▪ Pityriasis alba ▪ Seborrhoeic dermatitis ▪ Discoid eczema ▪ Hand eczema ▪ Asteatotic eczema ▪ Gravitational eczema ▪ Lichen simplex chronicus ▪ Prurigo nodularis
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- 5. Acute Eczema ▪ Intenseitching ▪ Intense erythema ▪ Oedema ▪ Papulovesicles ▪ Oozing ▪ HPE
- 6. Subacute eczema ▪ Erythema(lesser than in acute stage) ▪ Crusting and scaling ▪ Fissuring ▪ Slight to moderate itching ▪ Stinging and burning sensation
- 7. Chronic eczema ▪ Drynessof skin ▪ Excoriation ▪ Fissuring ▪ Lichenification - ▪ HPE-
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- 9. Irritant Contact Dermatitis ▪Non-immunologic inflammatory reaction of the skin ▪ due to an external agent. ▪ non sensitized
- 10. • Types: • Symptomaticresponses:-chloroform, methanol • Burns: Acid, Alkali • ICD- acute/chronic
- 11. • Acute IrritantDermatitis: • nature of substance • amount of substance • acid, alkali, solvents • erythema, edema, vesiculation, pruritus, tenderness • occupational in nature
- 12. • Chronic IrritantDermatitis: • patient characteristics + nature of substance • detergents- housewife dermatitis • oil mechanics-cutting oil
- 13. Paedrous Dermatitis • Dermatitislinearise/ whiplash dermatitis • organism: • irritant: • Season: • overnight onset
- 16. Allergic Contact Dermatitis •immunological-type IV
- 18. • Clinical Features: •Acute • Chronic
- 19. • Allergens: • metals •cosmetics • medicines • clothings
- 21. • Cosmetics: • fragrancesand preservatives • lipsticks • hair gels • nail polish
- 23. Allergens Sources Nickel, cobaltArtificial jewellery, jean buttons Chromium Cement, Painting Potassium dichromate Leather, detergents, paint Epoxy resins, phenols Plastics Parthenium Plants Propylene glycol Cosmetics, medicaments PPD Hair dyes Neomycin, gentamycin Topical medications Latex/ rubber gloves, shoes, belts PTBP Bindi
- 24. • MC metalallergen: • MC allergen in India: • MC topical medicine causing ACD:
- 26. Phytodermatitis: • MC causein India: • Allergen:Sesquiterpene lactones • Population:
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- 29. • Course: • Chronicrelapsing • more in summers and monsoons • Treatment: • Occupation change, reduce exposure • CS, AZA
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- 33. Phototoxic Photoallergic Incidence CommonLess Common Mechanism Non immunological TYPE IV Hypersensitivity Onset on UV exposure Minutes to days 24-28hrs Morphology of the lesion Sunburn Eczematous Diagnosis Clinically diagnosed Photo patch testing
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- 35. PMLE • MC formof immunologically mediated photosensitivity dermatoses. • DTH to an endogenous antigen expressed after exposure to UVA • typically appears after first exposure to intense sunlight in spring or summer • tends to recur annually
- 38. Patch Test: • Principle: •HS: • Indications: • site
- 39. reading: 48hrs (bestreading at 96 hrs)
- 40. • Photopatch: •Antigens applied in duplicate • covered with opaque material. • Onset is then irradiated with UVA At 48 hrs
- 42. • Management: • avoidirritants • topical steroids • oral steroids • AZA , cyclosporine • No retinoids
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- 44. Atopic Dermatitis • Definition:itchy, chronic or chronically relapsing inflammatory skin condition • Itch That Rashes/ itch is a disease
- 45. • Atopic Triad: Asthma Allergic Rhinitis (Hayfever) Atopic Dermatitis
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- 47. • Defective Barrier: •defect in fillagrin and locirin • decrease ceramides/lipids • increased TEWL
- 48. • Genetic Factors: •FLG gene • immune genes- IL4, IL13
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- 53. • Clinical Features: Infantile-3mnths-2 years adolescent-2yrs-12 yrs
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- 57. • hertoghe sign •allergic shiners-darkening beneath eyes • denny morgan fold
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- 62. • Diagnosis: • Clinical •High IgE • Criteria
- 64. • Management: • Removetriggers • Hydration • Pharmacological treatment
- 65. • 1st line: •Control of flare factors • Topicals • systemic
- 66. • Second line:I •Intensive topical therapy- step up to potent steroid ▪ Wet wrap technique ▪ Allergy management • Third line: ▪ Phototherapy ▪ Oral immunosuppresants • Cyclosporine • Azathriopine • Thymopentine • α- Interferon ▪ Desensitization
- 67. • Newer agents: •CRISABOLE-PDE 4 INHIBITOR-TOPICAL • DUPILUMAB: interleukin-4 (IL-4) receptor alpha antagonist- Systemic
- 68. Pityriasis Alba vs indeterminatehansen- endemic area, solitary lesion, no scaling, not episodic
- 70. Seborrheic Dermatitis • chronic,inflammatory papulosquamous disease • Organism:malassezia • Age: infants, adolescents, adults • Pathogenesis: increased sebum
- 71. • Other AssociatedDisorders: Parkinson’s , HIV • Sites:
- 73. < 3 months cradlecap maternal androgens
- 78. • Management: • nooil • Medicated shampoos : selenium sulphide or ketaconazole, ciclopirox olamine, tar and salicylic lotions. • Mild topical steroid or antifungals • antifungals • antihistamines
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- 80. Hand Eczema • endogenousor exogenous • ACD • ICD • focal peeling • hyperkeratotic • pompholyx
- 82. Pompholyx endogenous type B/L symmetrical sagograin deep seated vesicles itchy relapsing remitting
- 84. Asteatotic eczema NO FATRASH) (Eczema craquele, winter eczema) Elderly, topics winters shins cracked porcelain or ‘crazy paving’ pattern, dried riverbed)
- 86. Venous Eczema • Gravitational/stasis eczema • varicose veins • medial end of limbs
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