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Nutrition 2 (Semester II) > 13e. Skin Health - Atopic Dermatitis > Flashcards

13e. Skin Health - Atopic Dermatitis Flashcards

1
Q

What is atopic dermatitis?

A

Inflammatory skin disease
Altered skin barrier integrity and immune dysfunction

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2
Q

How does AD present clinically?

A

Pruritis with dry, red areas
Often on flexor/extensor surfaces
Face, scalp, neck, wrists, ankles
Lichenification
Papulovesicular lesions

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3
Q

What are the two types of AD?

A

Exogenous/extrinsic - IgE mediated
Endogenous/intrinsic - non IgE mediated

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4
Q

What are the two pathways implicated in AD?

A

Primary epithelial barrier disruption (outside in)
Immune response defect (inside out)

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5
Q

What is the primary epithelial barrier disruption (outside in) pathway in AD?

A

Disruption of tight junctions
Increased trans-epidermal water loss
Structural protein defects

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6
Q

What could the epithelial barrier disruption in AD be caused by?

A

Microbial colonisation
Release of inflammatory cytokines

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7
Q

What is the immune response defect (inside out) pathway in AD?

A

Defects in TLRs
Colonisation with S. aureus = inflammation
IgE mediated allergic sensitisation (secondary to structural epidermal defects)

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8
Q

What are the causes and risk factors for AD?

A

Th1/Th2 imbalance - hygiene hypothesis, C section, ABx etc
Stress
Filaggrin gene mutations
Nutritional deficiencies
EFA deficiencies/altered metabolism
Dysbiosis
Excess histamine

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9
Q

What can cause an EFA deficiency or altered metabolism?

A

Reduced delta-6 desaturase activity due to:
FADS2 SNP
Mg/B6/Zn deficiency
IR
Alcohol
High stress

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10
Q

An increase in which bacteria is associated with AD?

A

Clostridia spp
E. coli
S. aureus
Candida albicans
H. pylori

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11
Q

Which bacteria are seen in lower levels in AD?

A

Bifidobacterium
Bacteroidetes
Bacteroides

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12
Q

Why does H. pylori cause AD?

A

Stimulates epidermal cells to secrete thymic stromal lymphopoietin (TSLP)
Cytokine that induces inflammatory Th2 responses

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13
Q

Why can excess histamine be a risk factor in AD?

A

Disrupts tight junction integrity

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14
Q

What lab testing is done for AD?

A

FBC
Serum IgE
Allergy/food sensitivity - Cyrex
Comprehensive stool testing
Genetic panels

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15
Q

What are the allopathic treatments for AD?

A

Topical corticosteroids
Anti-histamines
Immunosuppressants

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16
Q

Naturopathic approach to supporting AD

A

Elimination of food triggers
Avoid anti-inflammatory foods - sugar, red meat, refined carbs
Address triggers and mediators
Address skin infections
Stress management

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17
Q

Which foods could trigger AD in children?

A

Cow’s milk
Eggs
Peanuts
Wheat
Soy
Fish

18
Q

Which foods may trigger AD in older children/adults?

A

Apple
Carrot
Celery
Hazelnut

19
Q

Examples of AD triggers and mediators

A

Environmental allergens - plants, dyes, airborne
Solvents, detergents, topical products
Heat, humidity, excessive bathing

20
Q

Dietary approaches to supporting AD

A

Naturopathic diet
Cooling foods
O3 - SMASH fish, flax, chia, spirulina
Quercetin rich foods - red apples, red onions, kale, blueberries
AIP diet - AD not AI but does increase risk
Pre/probiotics
5R protocol
Intestinal barrier support
Immunomodulatory support

21
Q

What herbs can be used for immunomodulatory support?

A

Echinacea - 4g
Turmeric - 500-2000mg
Boswelia - 250-500mg

22
Q

Nutrients to support AD

A

A
C
E
D
Zn
Se
EFAs
Quercetin

23
Q

How does vit A support AD?

A

Epithelial cell differentiation
Collagen synthesis

24
Q

Dosage of vit A to support AD

A

5000iu/day

25
Q

How does vit C support AD?

A

Improves overall epithelial barrier function
Collagen synthesis

26
Q

Dosage of vit C to support AD

A

1-2g/day

27
Q

How does Zn support AD?

A

Promotes keratinocyte differentiation
Reduces pro-inflammatory cytokines

28
Q

Dosage of Zn to support AD

A

15-30mg/day

29
Q

How does vit E support AD?

A

Supports skin water barrier
Reduces oxidative stress

30
Q

Dosage of vit E to support AD

A

Up to 600iu/day

31
Q

How does quercetin support AD?

A

Anti-inflammatory
Stabilises mast cells

32
Q

Dosage of quercetin to support AD

A

Up to 3g/day

33
Q

How does vit D support AD?

A

Normalising effect on Th1/Th2
Reduces IgE production

34
Q

How does Se support AD?

A

Anti-inflammatory
Enhances T cell function

35
Q

Dosage of Se to support AD

A

200mcg/day

36
Q

Example of a herb to support AD

A

Nettle

37
Q

How does nettle support AD?

A

Reduces effect of histamine
Cooling

38
Q

Dosage of nettle to support AD

A

500mg/day

39
Q

What lifestyle recommendations can be made to support AD?

A

Stress management
Dead sea salts bath
(Mg = improved barrier function, cell differentiation, hydration)

40
Q

Examples of herbs that can be used topically to support AD

A

Chamomile
Calendula
Lavender
(use lotions or aqueous carriers - not creams)

41
Q

Examples of herbs to use in the bath to support AD

A

Calendula
Oatseed
Chickseed
(place in muslin bag in bath as running water in)

Nutrition 2 (Semester II) (55 decks)

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