AD

Question 1

1st step in an atopic march

Answer 1

AD

Question 2

world wide cummulative prevalence

Answer 2

20%

Question 3

% atopic if parents are atopic

Answer 3

more than 1/4 of offspring of atopic morhers develop AD in first 3 mnths of life.
1 parent is atopic, more than half of children will dev allergic sx. both parents- 79%. n

Question 4

filaggrin prcesed by caspase 14 during terminal keratinocyte differentiation into highly hydroscopic pyrrolidone carboxylic acid and urocanic acid. collectively known as

Answer 4

Natural moosturizing factor ( NMF)

Question 5

Ichthyosis vulgaris is xaused by mutations in what gene?

Answer 5

FLG gene

Question 6

FLG mutations is also assoc w what 2 diseases independent of AD.

Answer 6

Ker pilaris.

allergic rhinitis

Question 7

what palm finding is strongly assoc w FLG mutation.

Answer 7

Hyperlinear palms.

71% ppv for marked palmar hyperlinearity.

Question 8

what dec gene expression lead to impaired sweating in AD

Answer 8

Dec claudin 3 expression

Question 9

IL elevated in AD

Answer 9

IL 17,22

Question 10

prevention in high risk.

Answer 10

Early moisturization statting before 3 wks of life w thick emollient may prevent AD.
probiotic admin during and after pregnancy dec AD by 14%

Question 11

How many percent hs food allergy?

Answer 11

35% of children mod to severe AD.
85% of chil w AD will hve elev igE to food or inhalant allergens making dx of food allergy challenging. high false positive rate.

Question 12

skin prick test ppv and npv

Answer 12

neg pred value >95%

Positive 30-65%

Question 13

How many percent of AD occur in 1st yr of life

Answer 13

50% or more.

usually not until 2 months.

Question 14

infantile pattern of AD disappears when ?

Answer 14

End ir 2nd yr of life.

Question 15

adult AD Aafter 18 yo is only composed of how many px of AD pxs?

Answer 15

6-14

Question 16

cutaneous stigmata/ signs.

Answer 16

Dennie morgan fold- below edge of lower eyelids.
headlight sign- nose is spared in extensice facial involvement. axillary vault and inguinal folds are spared due ti high humidity.
Nasal salute - nasal crease

Question 17

What is hertoghe sign?

Answer 17

thinning of lateral eyebrows. sometimes present.

Question 18

How many percent of AD develop cataract?

Answer 18

10%

Question 19

chronic eczemarous lesions are often colonized by?

Answer 19

S aureus.

Question 20

Bleach formula for AD n saureau infection

Answer 20

60 milliliters of bleach per 20 gallon bathtub water.

Question 21

pxs w AD hve inc susceptibility to viral super infection esp from

Answer 21

HSV, VZV, coxackieF vaccinia; molluscum.

Question 22

Easy most frequently in young children is usually associated with HSV type one transmitted from a caretaker or sibling.

Answer 22

eczema herpeticum

Question 23

EcZema herpeticum tx

Answer 23

Antiviral tx and anti staphylococcal antibiotic.

Question 24

Vaccination of ____ Is contraindicated in AD.

Answer 24

Small pox.

Question 25

histo

Answer 25

Hyperkeratosis; Acanthosis; Excoriation

Question 26

what class of steroid are for infants?

Answer 26

Low potency steroid ointments

Question 27

Tx in refractory relapsing AD

Answer 27

Twice a week steroid app to the areas that comkonly flare- reduce flares.
Ankther maintenance us to mix 1 part hydrocortisone 2.5% ointment in 1 to 4 parts if the patients preferred emollient 2-5 days per week.

Question 28

in older children, what potency is used?

Answer 28

med potency steroid. except on face. where milder steroids or calcineurin inh are preferred.

for thick plaques and LSC extremely potent steroids may be necessary.

Question 29

maintenance tx for steroids:

Answer 29

2x a week application mixing low potency steroid in with an emollient or with NSAID.

Question 30

% tacrolimus for children

Answer 30

0.03%

Question 31

dupilumab is a systemic tx blocks il4, il13. dec EASI score Exzema area and severity index. what is the side effect?

Answer 31

keratoconjunctivits.

Question 32

cyclosporine side effect

Answer 32

renal toxicity

Question 33

Methotrexate should be taken w

Answer 33

folic acid