Eczema CS-OSPE

Discoid Eczema, scaly, well demarcated, itchyZ

Infective eczema (Infected) / cellulitis + Hx topical steroid w/o responseZ

Allergic Dermatitis Eczema

Eczema CS-OSPE

Describe this lesion:Z

• Scaly plaque at heel, well demarcated, discoid margin
• Erythematous scaly plaque with demarcated margin

Diagnosis:

• What is the condition? Eczema
• If severely itchy, what’s the diagnosis? Discoid Eczema (Endogenous Chronic eczema)
• Infective eczema (Infected)
  • History context for Infective Eczema: Filipina presents with severe itching, clobetasol ointment (topical steroid) showed no improvement. Given Fucidin antibiotic + corticosteroids and showed dramatic improvement.
• Allergic Dermatitis (as a cause of pruritus)

DDx:

• Psoriasis
• Discoid eczema

Types & Causes:

• Endogenous
• Exogenous
• 2 Causes of pruritus: Allergic dermatitis
• 2 Types of pruritus:
  • Eczema
  • Scabies
  • cholastatic
  • hemorrhagic

Management/Treatment:

• How to manage?
  • Avoidants
  • EmollientsZ
  • Topical steroidsZ
• How to treat? Mild potent steroid and emollient
• For Infective eczema, how to manage?
  • Treat infection
  • Then start steroids

Special Considerations:

• When there’s a scale, what’s the 1st thing you do?
  • Scraping test → KOH, To exclude fungal infection
• Note: ID reaction: Fungal infection (e.g., pedis) can cause eczema in any site of the body. Can’t control eczema unless clearing the fungal infection first.

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#Z infective eczema

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Chronic Eczema with lichenification.

What is the Diagnosis?

• Chronic Eczema with lichenification.

What is the Clinical Presentation?

• Thickening of the skin.
• Macule.
• Patch.
• Fishers: lines due to lichenification which cause chronic itching.

What is the Pathology?

• Chronic skin condition associated with barrier dysfunction.
• Severe inflamed dermatitis.

What is the Treatment?

• Withdrawal or avoidance of the triggering substance if present.
• Emollients: 3 times/day & after bathing to combat dryness.
• Antihistamine: for itching.
• Anti-inflammatory/Steroid: depends on the area of the lesion & if treating a baby, give low potent.
• Antibiotic: if due to secondary infection.