Atopic

Question 1

*Atopic Dermatitis

Answer 1

is a chronic autoimmune, pruritic (itchy), and inflammatory skin condition most commonly affecting children worldwide (5–20%).

• It often presents in early childhood and tends to affect skin creases and flexure surfaces.

Question 2

Atopic dermatitis is often associated with allergic rhinitis and asthma, forming the atopic triad.

Answer 2

Approximately 80% of individuals with atopic dermatitis develop one or both of the other conditions.
- Food allergies (e.g., to eggs, milk, peanuts) are more common in these patients.

Question 3

Defective Epidermal Barrier**: Includes a deficiency in filaggrin, imbalances in protease activity, and tight junction abnormalities.

Answer 3

Immune Dysregulation**: Involves reduced function of TLR2 and TLR9 (innate immune system) and increased expression of TH2, TH17, and TH22 cytokines (adaptive immune system)

Question 4

Risk Factors**: Family history (genetics), allergies, and environmental factors like hard water.

Answer 4

Protective Factors**: Early exposure to daycare, pets, and farm animals, supporting the hygiene hypothesis.

Question 5

Can’t rely solely on a visual examination due to variability in appearance.

Answer 5

topic Stigmata**: Skin findings include keratosis pilaris, Denny-Morgan folds, Hertoghe’s sign, Pityriasis alba, palmar hyperlinearity, and retroauricular fissuring.

Question 6

Generally clinical, based on itchy, erythematous lesions typically found in skin folds.
- UK Criteria: Requires pruritic lesions plus at least three additional criteria (e.g., involvement of skin creases, history of asthma/hay fever, chronic dryness, early onset).

Question 7

Management and Treatment:

Answer 7

Avoid Triggers**: Environmental factors, stress, and possibly specific foods. The role of diet is controversial (e.g., dairy inclusion/exclusion).
- Medications:
- Topical corticosteroids: For local application except on face/eyelid/skin folds due to skin thinning risk.
- Topical calcineurin inhibitors: An alternative for sensitive areas.
- Phototherapy: For severe cases.

Question 8

Cyclosporine*: Short-term use for acute flares.
- Antihistamines: To manage pruritus.
- Melatonin: Potentially beneficial in some cases to aid sleep and symptom relief.