ECZEMA

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ECZEMA
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• Dermatitis
• Eczema
• Cutaneous reaction pattern
• Endogenous and exogenous factors
• Clinical stages
• Acute
• Subacute
• Chronic

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Classification
Exogenous eczema Endogenous enzema
Contact dermatitis Atopic dermatitis
Photodermatitis Seborrhoeic dermatitis
Infective- dematitis Varicose eczema
Astestotic eczema
Nummtor eczema
Pityriasis alba
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Atopic dermatitis

• Itchy, chronic fluctuating disease
• Family or personal history of atopy
• Several precipitation factors
• Infantile, childhood and adult phases

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Major Criteria

• Pruritus
• Early age of onset
• Typical morphology distribution
• Chronic relapsing course
• Personal of family history of atopy
• Diagnosis four major criteria

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Seborrhoeic dermatitis

• C/C dermatitis
• Etiology Malassezia
• Sebaceous glands
• HIV association

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Stasis eczema

• Secondary to venous hypertension
• Recurrent
• Acute, subacute, chronic

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Asteatotic eczema

• Dry skin
• Elderly Predisposing factors
• Frequent bathing, detergents, cold atmosphere,
  low humidity, malnutrition, drugs
• Site Leg (shins)

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Infective eczema

• Micro organisms and their products
• Clinical features
• Foci of infection
• Surround by
• Erythema and micro vesicles

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Contact dermatitis

• Irritant contact dermatitis
• Allergic contact dermatitis

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Irritant contact dermatitis

• No immunological memory
• No antibody formation
• Inflammatory responses to exogenous agents

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Predisposing factors

• Individual
• Age, sex site Eczema
• Environmental
• Temperature
• Humidity
• Occlusion
• Nature of
• Chemical
• Physical
• Factors

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Clinical features

• Subjective
• Objective
• Acute irritant contact dermatitis
• Cumulative insult dermatitis
• Contact urticaria

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Allergic contact dermatitis

• Type IV immunological reaction
• Sensitization
• Predisposing factors
• Clinical features Eczematous
• Non eczematous

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Photodermatitis

• Topical / Systemic
• UV ? visible light
• Irritants / allergens
• ? ?
• Phototoxic photoallergic

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Complications

• General
• Secondary infection
• Autoeczematization
• Exfoliative dermatitis
• Specific complications
• Stocking erythrodema
• Lipodermatosclerosis
• Kapopsis varicelliform eruption
• Eczema herpeticum
• Baboon syndrome

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Management

• Diagnosis
• History
• Aggravating factor
• Precipitating factors
• Occupation
• Hobbies
• Allergy to drugs
• Clinical examination
• Other tests-patch test

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• Acute eczema
• Rest
• Antihistamine
• Antibiotics
• Compresses
• Normal saline
• Dill potassium permanganate
• Emollients
• Topical antibiotics
• Topical steroids