Sign up here!
image

Eczema

Atopic eczema is the most common type of eczema (dermatitis) that results in a pruritic erythematous rash and usually affects flexor surfaces.

Suggested approach to atopic eczema osce station

Examine

Describing lesions

  • Lesions
    • ‘There are multiple papules and vesicles with an erythematous base distributed over the flexor surfaces.’
    • ‘These range in size from 1-6mm.’
    • ‘There is some evidence of lichenification and scaling but no evidence of secondary infection or eczema herpeticum.’
    • ‘These lesions are consistent with atopic eczema.’

Differential diagnosis

  • Other types of eczema

If allowed to ask patient questions

  • Personal/family history of asthma, hay fever, eczema

Types of eczema

  • Exogenous: irritant contact, allergic contact, photocontact/photosensitive, photo-allergic
  • Endogenous
AtopicMost common and described here
SeborrhoeicGreasy/scaly erythematous rash around nose, ears and scalp
AsteatoticCracked skin, often on lower limbs
DiscoidCoin-like lesions
Pityriasis albaPink scaly patches that later leave hypopigmentated areas of skin
PompholyxItchy blisters on hands and feet
VaricoseAssociated with chronic venous insufficiency; affects lower limbs

Associations

  • Atopic individuals/families
    • Asthma
    • Hay fever
    • Eczema

Management

  • Topical treatments
    • Emollients and bath/shower substitutes
    • Corticosteroids (e.g. hydrocortisone, mometasone)
    • Calcineurin inhibitors (e.g. pimecrolimus, tacrolimus)
  • Others
    • Identify and avoid allergens
    • Antihistamines for persistent pruritus/sleep disturbance
    • Phototherapy if other treatments fail
    • Antibiotics if secondary infection

Questions

What is a fingertip unit?

Oops! This section is restricted to members.

Create an account or log in to continue reading.

Please list two complications of eczema

Oops! This section is restricted to members.

Create an account or log in to continue reading.

What may exacerbations in eczema be associated with?

Oops! This section is restricted to members.

Create an account or log in to continue reading.

Now try a station

  1. Dermatological skin exam
  2. Eczema exam
  3. Eczema history
  4. Find more here
image
Previous
Psoriasis
image
Join our email list!
For free OSCE tips and updates