1.3 Atopic Dermatitis Flashcards
How old does eczema usually present?
3-4month up to 12 months
What is infantile seborrhoea dermatitis?
Neck folds, cubical, popliteal, groin, usually becomes atopic dermatitis
Where does pompholyx happen?
Hands and soles of feet
2 factors that determine resolution of atopic dermatitis?
Avoid environmental
Anti-inflammatory
Immune dysregulation in atopic dermatitis which cells?
Dendritic
T-cells
Prefers Th2
All patients need consideration of what factors in atopic dermatitis?
Environmental irritants
Infection
What kind of environmental irritants are there for atopic dermatitis?
Drying agents Abrasive clothing Abrasive surfaces Heat Chemicals, fragrance, preservatives
atopic dermatitis and infection with which bug?
S.Aureus colonisation, super antigen phenomenon
2 types of anti inflammatory therapy?
Topical steroids
Prime role us, tacrolimus: calcineurin inhibitors
What is the mnemonic ECEMA?
E - existing diagnosis correct? C - co-existent disease E - environmental all accounted? M - medications adequate? A - allergy or intolerance?
Other DDx of atopic dermatitis?
Scabies
Psoriasis
Miliaria
Is psoriasis itchy?
Not really
What is ichthyosis vulgar is?
Very dry skin
What is co-existent disease processes?
Infection
Ichthyosis vulgaris
Immunodeficiency?
(Failure to thrive, infection, persistent diarrhoea)
What co infections to look out for in atopic dermatitis?
Staph
HSV
Strep
Which topical steroid for face?
Hydrocortisone
What are airborne allergens?
Dust mite
Pollens
Grasses
Animals
How to confirm airborne allergens?
Skin prick or RAST
What to do if you suspect atopic dermatitis + allergy?
Skin prick, RAST
Elimination diet/food challenge
Avoidance measure
Match results with clinical features
What is mainstay treatment for face for atopic dermatitis?
Hydrocortisone
What do you use for trunk, and open flexures?
Advantin ointment
Topical pincrolimus roll us/tacrolimus
atopic dermatitis phototherapy?
Narrow band-UVB
atopic dermatitis oral immunosuppressive for severe use?
Methotrexate/azathioprine
How to use topical steroid time period wise?
10 days on, 4 days off
Cyclic use
What to monitor for topical steroids in atopic dermatitis?
Consumption: how much (should decrease)
Side effects
atopic dermatitis successful management needs 3 things?
Environment (most important)
Dietary
Anti-inflammatory
