Dermatitis: The Daily PANCE Blueprint

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Dermatitis: The Daily PANCE Blueprint

A 19-year-old male with a history of allergies and asthma presents to the clinic complaining of itchy lesions he has been told is “eczema.” A physical exam reveals antecubital hyperpigmentation and lichenification. Similar types of lesions are starting to appear on the right side of his face as well. Which of the following would you want to avoid for treatment of his facial lesions for more than 4 weeks?

A. Lubrication
B. Topical steroids
C. Water-based moisturizers
D. Pimecrolimus cream
E. Tacrolimus ointment

Answer and topic summary

The answer is B. Topical steroids

Atopic dermatitis is chronic, inflammatory skin disease. Risk factors include genetics and environmental exposures. Clinical features include pruritus, dry skin, and erythematous papules and vesicles with exudation and crusting. Skin thickening and lichenification may develop over time. Classically the lesions are located on the neck, face, and flexor surfaces of the arms. The diagnosis is often clinical. Management includes avoiding exacerbating factors, optimizing skin hydration with emollients/moisturizers, topical steroids, oral H1 antihistamines for pruritus, and topical calcineurin inhibitors. It’s important to note that topical steroids shouldn’t be used for a long time on the face because it can lead to pigment changes, acne eruptions, telangiectasis, striae, and atrophy.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Dermatology ⇒ Papulosquamous Disorders (PEARLS) ⇒ Dermatitis

Also covered on the Emergency Medicine EOR and Family Medicine PAEA rotation content topic list

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