Atopic Dermatitis and Dry Skin Flashcards

1
Q

What is Atopy?

A
  1. Genetic tendency to develop allergic diseases

2. Heightened immune response to common allergens

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2
Q

What is dermatitis?

A

Dermatologic condition characterized by erthema and inflammation

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3
Q

What is dermatitis interchangeable with?

A

Eczema

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4
Q

What is Atopic dermatitis?

A

Inflammatory condition of the dermis + epidermis; episodic flares and remissions are common

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5
Q

Which layer of the skin controls drug transport?

A

Epidermis

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6
Q

Which layer of the skin contains nerve endings, vasculature, and hair follicles?

A

Dermis

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7
Q

Which layer of the skin provides nourishment, cushions the other two layers?

A

Hypodermis

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8
Q

Which layer of the skin regulates H20 content?

A

Epidermis

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9
Q

What is the most important function of the skin?

A

Protects body from external agents and pathogens/chemicals

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10
Q

What is the issue with aging skin?

A

More fragile and take slonger to heal after injury

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11
Q

Ointments are _____-based

A

petrolatum

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12
Q

Lotions are _____-based

A

water

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13
Q

Powders are (hydrophobic/hydrophilic)

A

Hydrophilic

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14
Q

What is the major mechanism for drug absorption?

A

Passive diffusion

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15
Q

What is the rate-limiting barrier in drug absorption?

A

Stratum Corneum (epidermis)

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16
Q

Increase of hydration of Stratum Corneum will ______ drug absorption

A

increase

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17
Q

Which situation will allow the greatest drug absorption?

A

When wounds, infections, burns, etc are present. Alter Stratum Corneum and acts like a shunt

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18
Q

Who should you automatically refer to PCP with major skin problems? Why?

A

<1 yrs old

BSA for neonates are 2-3 times compared to adults which allows for more drug absorption

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19
Q

What are the most common disorders in children due to atopy?

A
  1. Asthma
  2. Allergic rhinitis
  3. Atopic dermatitis
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20
Q

What makes up 80% of atopic disorders symptoms?

A

Asthma + allergic rhinitis

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21
Q

How would you diagnose atopic disorder?

A

a pruritic skin disorder + 3 or more of the following:

Onset <2 yrs old
History of skin crease involvment
History of dry skin
Personal history of other AD
Visible flexural dermatitis
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22
Q

What are the three forms of AD?

A

Acute, subacute, chronic

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23
Q

What bacteria is common in AD patients?

A

90% Staph. Aureaus and possibly Strep

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24
Q

What visual cue is common in AD patients?

A

Yellowish crusting

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25
Q

When should you seek medical attention in AD patients?

A

Pustules, vesicles, and crusting forms

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26
Q

What is the hallmark symptom in AD?

A

Pruritus

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27
Q

How does AD present in infants?

A

Red scaling of cheeks, progresses to face, neck and trunk

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28
Q

What are the 4 goals in treating AD?

A
  1. Stop the itch - scratch cycle
  2. Hydrate skin
  3. Avoid/minimize triggers
  4. Prevent 2nd infections
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29
Q

What can you stress to patients about AD?

A

AD cannot be cured, but rather managed

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30
Q

Exclusion to AD: (T/F)

<2 years old

A

False; <1 years old

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31
Q

Exclusion to AD: (T/F)

Infection

A

True

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32
Q

Exclusion to AD: (T/F)

Intense itching + affects large area

A

True

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33
Q

Exclusion to AD: (T/F)

Involvement of intertriginous areas

A

True

34
Q

Nonpharmacolgic treatments for AD: (T/F)

Bath with cold water

A

False; luke-warm water

35
Q

Nonpharmacolgic treatments for AD: (T/F)

Apply moisturizer one hour after bath

A

False; immediately after

36
Q

What are the nonpharmacolgic treatments for AD

A

Bathe in luke-warm water and apply mosturizer immediately after bath

37
Q

What is better for AD, wool or cotton?

A

Cotton

38
Q

What kind of clothes should you wear if you have AD?

A

Anything is fine except if it is tight-fitting

39
Q

What is the treatment of choice for dry, scaly, or fissured lesions?

A

Ointments

40
Q

What kind of moisturizer is used for lubrication?

A

Cream

41
Q

What kind of moisturizer is non-greasy?

A

Lotions / Gels

42
Q

What kind of moisturizer dries quickly?

A

Lotions / Gels

43
Q

What kind of moisturizer spreads more easily?

A

Lotions / Gels

44
Q

What kind of moisturizer should be avoided on intertriginous areas?

A

Ointments

45
Q

What kind of moisturizer should be avoided on weeping or oozing lesions?

A

Ointments

46
Q

What kind of moisturizer used in hairy areas?

A

Lotions / Gels

47
Q

Creams vs Ointment; which is more greasy / potent?

A

Ointment

48
Q

What is the typical ingredient in butter?

A

Shea butter

49
Q

What kind of moisturizer is occlusive in warm weather?

A

Ointments

50
Q

What is the MOA for emollients?

A

Deposits oily film on skin to prevent moisture escape

51
Q

How do emollients and humectants differ?

A

Emollients retain the water already present

52
Q

What is the MOA for humectants?

A

Draws water into the straum corneum to hydrate skin

53
Q

Emollinet vs humectant; which is the standard of care?

A

Emollients

54
Q

What is the MOA for topical corticosteroids?

A

Relieves pruritic and reduce inflammation

55
Q

When should you apply topical corticosteroids?

A

1-2 times daily BEFORE moisturizers

56
Q

How long can you use topical corticosteroids before consulting w/ physician?

A

7 days or less

57
Q

Who should not use topical corticosteroids?

A

< 2 yrs old

58
Q

If lesions are oozing, what kind of moisturizer should be used?

A

Creams

59
Q

What are some complementary therapies?

A

Coal tar, bleach bath (1/2 cup to 40 gallons), and wet wraps

60
Q

What are some things to avoid for the skin? Recommended?

A

Topical anesthetics + topical antihistamines

Oral antihistamines

61
Q

How do oral antihistamines help?

A

Help sleep and reduce scratching at night

62
Q

What is another name for dry skin?

A

Xerosis

63
Q

How many ppl are affected by dry skin?

A

> 50% older adults

64
Q

What is the common cause of pruritus?

A

Dry skin

65
Q

Dry skin is the common cause of _______

A

pruritus

66
Q

What causes dry skin?

A

Disruption of keratinization and desquamation; loses water in skin and loss of cells from stratum corneum

67
Q

Which layer gets thinner as you get older?

A

Epidermis; produces roughened skin surface

68
Q

What are some nonpharmacolgic treatments for dry skin?

A

Keeping humidity higher than normal, moisturize w/ humectant or keratolytic agents, stay hydrated, take bath oils

69
Q

What should you avoid if you have dry skin?

A

Caffeine, spices, and alcohol

70
Q

What are some pharmacologic treatments for dry skin?

A

Severe case: urea / lactic acid

Topical hydrocortisone

71
Q

What is a short-term pharmacologic treatment for dry skin?

A

Topical hydrocortisone (ointment)

72
Q

When should you report to PCP when using hydrocortisone?

A

Thinning of skin

73
Q

When should you consult PCP in treating AD / dry skin?

A

2-3 days for AD

7 days for dry skin

74
Q

As you age, sebum levels will ______

A

decrease

75
Q

How effective are bath oils?

A

Minimally effective, more effective if used as a wet compress

76
Q

Which kinds of soaps are close to neutral pH?

A

Glycerin

77
Q

Which moisturizer promotes occlusive?

A

Ointments

78
Q

Increase in occlusive (increase/decrease) lipids

A

increase

79
Q

What binds to skin protein and is useful for crusted, necrotic tissue?

A

Urea (also a humectant)

80
Q

What is the only OTC drug approved for dermatitis?

A

Hydrocortisone

81
Q

Hydrocortisone vs Ointment; which is the better option for chronic, non-oozing dermatoses?

A

Ointments

82
Q

When should you not use antihistamines?

A

Person w/ BPH (benign prostate hyperplasia) or glaucoma