Andrews Chapter 5: Atopic Derm, Eczema, and Immunodef Flashcards
Gene mutation found in atopic dermatitis
FLG mutation
Treatment of eczema herpeticum
systemic antiviral + antistaph antibiotic (batrim, clinda, cephalosporin, doxy) given common secondary ifxn; also ophtho c/s if eye involvement
Phototherapy protocol for atopic dermatitis
Initial dose lower, and escalate slower than for pts with psoriasis, to prevent flare. May also consider pre-tx with systemic immunosupp to cool off skin first
Systemic immunosup therapies for AD
cyclosporine (rapid acting), MMF/azathioprine (take at least 6 weeks for effect), MTX; IVIg, IFN; keep systemic steroid use to
Severe diaper dermatitis spectrum
Jacquet erosive diaper dermatitis, Granuloma gluteal infantum, pseudoverrucous papules and nodules
Ddx of diaper dermatitis
napkin psoriasis, seb derm, AD, langerhans cell histiocytosis, tinea cruris, acrodermatitis enteropathica, aminoacidurias, biotin deficiency, congenital syphilis
Epidermal changes with aging
Decreased epidermal barrier and increased pH (benefit from mild acids in treating xerosis); also immune system skewed towards Th2
Tx for autoimmune progresterone dermatitis
OCP - to suppress ovulation and progresterone levels; urticaria or EM-like lesions 5-7 days before menses, resolve soon after period; also consider autoimmune estrogen dermatitis
X-linked agammaglobulinemia (Bruton) mutation and clinical findings
BTK gene mut, essential for B lymph devel; upper/lower resp and GI ifxn; recurrent skin staph ifxn; usu at >4mo (since initially have mother’s ig); tx with gamma globulin
Pts with isolated IgA deficiency are at risk for what?
anaphyl with transfusion or IVIg, increased risk of autoimmune dz and malig; also GI/resp ifxn; may be med induced
Common variable immunodeficiency phenotype and at risk for what?
Low IgG, IgA (sinopulm ifxn); 50% with low IgA; also increased risk of autoimmune dz and malig (GI, lymphoma); granulomas
