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

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 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