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Written with the participation of FDVF (Future Dermatologists and Venereologists of France) interns.
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23 respondents
Question of 1
Mycosis
Wrong answer!
It was atopic dermatitis.
Let’s rule out differential diagnoses:
Also found in typical locations: elbows, knees, lumbar region, scalp, +- nails with a context or history of psoriasis, without the atopic context or animal contact.
Histology if necessary.
Flare-ups with periods of remission, history of atopy, pruritus, xerosis.
Location of the lesions: face, skin folds, limbs.
Jagged eczema lesions.
No infectious contact or animals.
Lesions with geographic edges, inflammatory at the edges, with scarring at the centre, centrifugal, recent +- pruritic. Animal contact and mycology if necessary.
Atopic dermatitis
Atopic dermatitis
It is indeed atopic dermatitis.
Let’s rule out differential diagnoses:
Also found in typical locations: elbows, knees, lumbar region, scalp, +- nails with a context or history of psoriasis, without the atopic context or animal contact.
Histology if necessary.
Flare-ups with periods of remission, history of atopy, pruritus, xerosis.
Location of the lesions: face, skin folds, limbs.
Jagged eczema lesions.
No infectious contact or animals.
Lesions with geographic edges, inflammatory at the edges, with scarring at the centre, centrifugal, recent +- pruritic. Animal contact and mycology if necessary.
PSORIASIS:
Psoriasis
Wrong answer!
It was atopic dermatitis.
Let’s rule out differential diagnoses:
Also found in typical locations: elbows, knees, lumbar region, scalp, +- nails with a context or history of psoriasis, without the atopic context or animal contact.
Histology if necessary.
Flare-ups with periods of remission, history of atopy, pruritus, xerosis.
Location of the lesions: face, skin folds, limbs.
Jagged eczema lesions.
No infectious contact or animals.
Lesions with geographic edges, inflammatory at the edges, with scarring at the centre, centrifugal, recent +- pruritic. Animal contact and mycology if necessary.
Topical corticosteroids can be prescribed as firstline therapy. What is dangerous is steroid phobia!
In short: potent class such as betamethasone.
- Either once or twice a week if flare-ups are frequent
- Or discontinue topical corticosteroids and resume
Use of emollients: at least once a day – that is the basic principle behind maintenance treatment for AD! Moisturises, reduces micro-inflammation and pruritus, regulates the microbiome, eliminates the need for cortisone.
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