Atopic Dermatitis

Question 1

MC chronic relapsing skin disease seen in infancy and childhood

Answer 1

Atopic dermatitis

Question 2

Atopic dermatitis (AD) is aka

Answer 2

Atopic eczema

Question 3

What is the “atopic march”

Answer 3

Development of AR and/or asthma later in childhood in children with AD

Question 4

Cell population responsible for exaggerated immune response seen in patients with AD

Answer 4

T cells

Question 5

Acute vs chronic AD lesion: Spongiosis or marked intercellular edema of the epidermis

Answer 5

Acute

Question 6

Acute vs chronic AD lesion: Hyperplastic epidermis with hyperkeratosis and minimal spongiosis

Answer 6

Chronic

Question 7

2 forms of AD

Answer 7

1) Atopic eczema 2) Nonatopic eczema

Question 8

Form of AD associated with IgE-mediated sensitization (70-80%)

Answer 8

Atopic eczema

Question 9

Form of AD not associated with IgE-mediated sensitisation (20-30%)

Answer 9

Non-atopic eczema

Question 10

Hallmark of AD

Answer 10

Severely dry skin

Question 11

A component of the cytoskeleton, the breakdown products of which are critical to skin barrier function

Answer 11

Filaggrin

Question 12

Genetic mutations in the filaggrin gene have been identified on ___% of severe AD patients

Answer 12

50%

Question 13

Cardinal features of AD (2)

Answer 13

1) Intense pruritus, especially at night 2) Cutaneous reactivity

Question 14

Fibrotic papules characteristic of chronic AD

Answer 14

Prurigo nodularis

Question 15

AD, infants/younger vs older children: More acute

Answer 15

Infants/younger children

Question 16

AD, infants/younger vs older children: Lichenification

Answer 16

Older children

Question 17

AD, infants/younger vs older children: Extensor surfaces of extremities

Answer 17

Infants/younger children

Question 18

AD, infants/younger vs older children: Face and scalp

Answer 18

Infants/younger children

Question 19

AD, infants/younger vs older children: Flexural folds of extremities

Answer 19

Older children

Question 20

T/F AD in infants/younger children is characterized by sparing of diaper area

Answer 20

T

Question 21

Major clinical features of AD (4)

Answer 21

1) Pruritus 2) Facial and extensor edema in infants and children/Flexural eczema in adolescents 3) Chronic or relapsing dermatitis 4) Personal or family history of atopic disease

Question 22

Adolescents who present with an eczematous dermatitis but no history of childhood eczema, respiratory allergy, or atopic family history may have what disease entity

Answer 22

Allergic contact dermatitis

Question 23

Cornerstone of anti-inflammatory treatment for acute exacerbations of AD

Answer 23

Topical corticosteroids

Question 24

Co-morbid condition in approximately 40% of infants and young children with moderate to severe AD

Answer 24

Food allergy

Question 25

Organism found in >90% of AD skin leasions

Answer 25

S. aureus

Question 26

Most serious viral infection associated with AD

Answer 26

Kaposi varicelliform eruption or eczema herpeticum caused by HSV

Question 27

Mainstay for prevention of flares as well as for long term treatment of AD

Answer 27

Identification and elimination of triggering factors

Question 28

Criteria for the diagnosis of AD

Answer 28

Evidence of itchy skin (or parental report of scratching or rubbing) PLUS 3 or more of the ff: 1) History of skin crease involvement 2) History of asthma or allergic rhinitis (or history of atopic disease in a first-degree relative if child is less than 4y/o) 3) History of generally dry skin in the past year 4) Onset in a child less than 2y/o 5) Visible flexural dermatitis (including dermatitis affecting cheeks, forehead, and outer aspects of limbs in children less than 4y/o

Question 29

5 criteria for diagnosis of AD are not used if the child is how old

Answer 29

Less than 4 years of age