Atopic dermatitis Flashcards
What is atopic dermatitis?
Atopic dermatitis is a distinctive pruritic eczematous condition of the skin, characterized by inflammation of the dermis and epidermis. It can be acute, subacute, or chronic, with symptoms that may change quickly and often.
What is the hallmark symptom of atopic dermatitis?
The hallmark symptom of atopic dermatitis is intense itching, often referred to as “the itch that rashes.”
What are the phases of inflammation in atopic dermatitis?
The phases include:
Acute: Redness, swelling, papules, blisters, oozing, crusting.
Subacute: Red, drier, scalier skin with pigment changes.
Chronic: Lichenification, excoriations, scaling, crack
Where are lesions typically located in infants with atopic dermatitis?
Lesions are often found on the face, wrists, and extensor sites.
Where are lesions commonly found in children with atopic dermatitis?
Lesions commonly appear in the antecubital and popliteal fossae (inside elbows and knees), neck, and abdomen.
Where are lesions typically located in adults with atopic dermatitis?
Lesions are found in flexures, front and sides of the neck, eyelids, forehead, face, wrists, and dorsa of feet and hands, often generalized.
What is the “Brick-Wall Concept” in the context of atopic dermatitis?
The “Brick-Wall Concept” refers to the structure of the epidermal barrier, where corneocytes act as bricks and lipid layers as mortar. A defect in this barrier can lead to inflammation, infection, and allergen penetration
What are the major criteria for diagnosing atopic dermatitis according to Hanifin and Rajka?
The major criteria include:
Pruritus (itching)
Typical morphology and distribution
Flexural lichenification in adults
Facial and extensor involvement in infants
Chronic relapsing course
Personal or family history of atopy (such as hay fever, asthma, rhinitis, or atopic dermatitis
What are some of the minor criteria for diagnosing atopic dermatitis?
Minor criteria include:
Xerosis (dryness)
Ichthyosis/palmar hyperlinearity/keratosis pilaris
Immediate (type I) skin test reactivity
Elevated serum IgE
Early age of onset
Tendency towards cutaneous infections (Staphylococcus aureus and Herpes simplex)
Tendency towards nonspecific hand or foot dermatitis
Nipple eczema
Cheilitis
Recurrent conjunctivitis
Dennie-Morgan infraorbital fold
What is the purpose of the prick test in the context of atopic dermatitis
The prick test is used to detect IgE-mediated immediate-type hypersensitivities, helping identify allergens that may trigger atopic dermatitis
What are the common bacterial complications associated with atopic dermatitis
Bacterial infections are common complications, particularly with Staphylococcus aureus and Streptococcus
What viral infections can complicate atopic dermatitis?
Viral complications can include warts, molluscum contagiosum, and eczema herpeticum (a potentially life-threatening varicelliform eruption caused by herpes simplex virus
What is a common approach for controlling itching in atopic dermatitis?
H1 antihistamines and behavior control strategies can help manage itching
How does tacrolimus work?
Tacrolimus is a calcineurin inhibitor that suppresses the immune system by inhibiting T-cell activation, which helps reduce skin inflammation
what is the treatment approach to atopic dermatitis
general measure: education, skin irritants & psychological support
topical treatment: emollients, steriods, calcineurin inhibitors
systemic : antihistamines
