Discoid Eczema Infective eczema (Infected) Allergic Dermatitis Eczema

Eczema CS-OSPE

Describe this lesion:

  • 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
    • Emollients
    • Topical steroids
  • 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.