AD

Question 1

hos many percent of infants with AD will devp asthma in the future?

Answer 1

35% o in ants

with AD develop asthma later in li e

Question 2

agw of onset. percent ofcuring by 2 mos,5yrs and 6-20

Answer 2

First2monthso lieandbythe rstyearsin60%o patients;30%byage5,and
only 10% between age 6 and 20 years. Rarely AD has an adult onset.

Question 3

gender

Answer 3

males

Question 4

what season does it flare

Answer 4

AD usually improves in summer and ares in winter

Question 5

acute ans d chronic ad is assoc w what interleukins

Answer 5

Acute AD is associated with a predominanceo interleukin(IL)4andIL-13 expression,andchronicin ammationin
AD with increased IL-5, granulocyte-macro- phagecolony-stimulating actor,IL-12,and inter eron-γ .

Question 6

tx acute subacute and chronic

Answer 6

Acute
1. Wet dressings and topical glucocorticoids; topical antibiotics (mupirocin ointment) when indicated.
2. Hydroxyzine, 10 to 100 mg our times daily or pruritus.
3. Oral antibiotics (dicloxacillin, erythromy- cin) to eliminate S. aureus and treat MRSA according to sensitivity as shown by culture.
Subacute and Chronic
1. Hydration (oilated baths or baths with oat- mealpowder) ollowedbyapplicationo unscented emollients (e.g., hydrated petro- latum) is basic daily treatment to counteract xerosis; 12% ammonium lactate or 10% α-hydroxyacidlotionisverye ective or xerosis. Soap showers are permissible or the body olds, but soap should seldom be used on the other parts o the skin sur ace.
2. opicalanti-in ammatoryagentssuchasglu- cocorticoids, hydroxyquinoline preparations arethemainstayso treatment.O these,glu- cocorticoidsarethemoste ective.However, topical glucocorticoids may lead to skin atro- phyi used orprolongedperiodso timeand i usedexcessivelywillleadtosuppressiono the pituitary–adrenal axis. Another problem is “glucocorticoid phobia.” Patients or their parentsareincreasinglyawareo glucocorti- coidsidee ectsandreusetheiruse,nomat- terhowbene cialtheymaybe.
3. T e calcineurin inhibitors, tacrolimus and pimecrolimus, are gradually replacing glu- cocorticoidsinmostpatients.T eypotently suppressitchingandin ammationanddonot leadtoskinatrophy.T eyareusuallynote ec- tive enough to suppress acute ares but work very well in minor ares and subacute AD.
4. Oral H -antihistamines are use ul in reduc- 1
ing itching.
5. Systemic glucocorticoids should be avoided,
exceptinrareinstanceso severeintractable disease in adults

Question 7

prurigo nodularis tx

Answer 7

intralesionaltriamcinolone,occlusivedressingswithhigh-potencyglucocorticoids.In
severecases,thalidomide50to100mg.Watchout orcontraindications.Neurotonin300mgpotid is sometimes help ul

Question 8

tx dishydrotic eczema

Answer 8

Treatment:topicalhigh-potencycorticosteroids,intralesionaltriamcinolone 3mg/mL orsmallareas;
inseverecases,ashortcourseo prednisone:startingwith70mgandtaperingby10or5mgover7 or14days;systemicantibiotics orsecondaryinectionandPUVAeitheroraloras“soaks