Atopy Flashcards
What is healing by delayed primary intent?
Contaminated or devitalized tissue demarcates by 4 days
clean wound and repair
What type of healing is done with wounds that have dehisced?
Secondary–surgical wounds
What is the care for partial thickness wounds?
No closure, skin care only–will reepithelialize fine
What is the major difference in the healing process between primary and secondary intent?
Primary has a much smaller plug than secondary
How long is the inflammatory stage of wound healing?
6 days ish
What are the three major stages of wound healing?
Inflammatory
Granulation/proliferation
Remodeling/maturation
When does a wound reach its final strength?
12 weeks out
Should you use abx with wounds? Why or why not?
No–just breeds resistance
Why is smoking bad for wound healing?
Vasoconstriction
Atopic dermatitis usually develops by what age, and resolves by what age?
Develops by 5 years, and resolves by adolescence
What is the primary symptom of atopic dermatitis?
itch that rashes
What are the skin findings with AD?
Erythematous papules, which then coalesce to form erythematous plaque that may weep
Where is the rash commonly found with AD in infants and toddlers?
cheeks, forehead, and extensor surfaces
Where is the rash commonly found with AD in older children and adolescents?
Lichenified rash in flexural areas of the neck, elbows, wrists, and ankles
What does lichenified mean?
Plaque formation in reponse to chronic scratching
Where is the rash commonly found with AD in adults?
Lichenified rash in flexural regions and in feet / face
What is the common characteristics of AD rash in all ages?
Xerosis
What percentage of children with atopic dermatitis also have or will develop asthma or allergic rhinitis?
50-80%
What is the atopic triad?
Asthma
Atopic dermatitis
Allergic rhinitis
What is samter’s triad?
Aspirin Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad or Aspirin Sensitive Asthma, is a chronic medical condition that consists of asthma, recurrent sinus disease with nasal polyps, and a sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).
What are the factors that are thought to play a role in the development of atopic dermatitis? (4)
- Genetics
- Skin barrier dysfunction
- Impaired immune response
- Environment
What is the treatment for atopy?
Gentle cleansing,. pat dry, and emollients
What should be used for anti-inflammation with itching?
Mild steroid
What should be used as an antipruritic for atopy?
Antihistamine
What type of moisturizer should be used for itchy skin?
greasy without smells
What abx should be used for itchy skin?
Anti staph
What is the medium that should be used for mild steroids on the face?
hydrocortisone ointment
What is filaggrin? What is its function, and role in atopy?
- protein found in the stratum granulosum cell layer of the epidermis
- Retains water within keratinocytes
- Mutations cause AD
What is harlequin baby?
a severe genetic disorder that mainly affects the skin. Infants with this condition are born with very hard, thick skin covering most of their bodies. The skin forms large, diamond-shaped plates that are separated by deep cracks (fissures)
lethal
What is pityriasis alba?
Variant of atopic dermatitis that causes irregular, white patches
What are the characteristics of pityriasis in the summer and winter?
Summer = hypopigmentation Winter = dry/scaly
How do you differentiate pityriasis alba from fungi?
Woods lamp - and mycology -
What is the treatment for pityriasis alba?
Emollients and mild steroid ointment
What type of hypersensitivity reaction is allergic contact dermatitis?
Tpye IV
What is the treatment for allergic contact dermatitis?
Topical steroids, oral antihistamine
How long does it take for s/sx to appear with contact dermatitis?
12-48 hrs
What is urticaria? What layer of the skin is affected?
a vascular reaction of the skin, characterized by wheals surrounded by a red halo or flare
Swelling of the uppe dermis
what is the cardinal symptom of urticaria?
Pruritis
Wheal and flare = ?
Urticaria
What, generally, is angioedema?
deep dermis and SQ swelling
What are the s/sx of angioedema?
- Face edema
- Painful or burning, but NOT pruritic
what is the appearance of angioedema?
Like water filled skin
How fast does urticaria present?
Within minutes, and disappear within hours
What is the difference between acute and chronic urticaria
- Acute = less than 6 weeks
- chronic = more than 6 weeks
Do urticaria blanch?
Yes
True or false: most urticaria is acute, and will resolve
true
True or false: many patients with chronic urticaria have physical factors that contribute
True
What is dermatographism?
fast development of urticaria following scratching
What is the major effector cell in urticaria?
Mast cell
What is immunologic urticaria?
Antigen binds to IgE on the mast cell surface, crosslinking it, and releasing histamine
What is the pathogenesis of non-immunologic urticaria?
Drugs directly cause histamine release, no IgE crosslinking needed
What are the three major forms of non-immunologic urticaria?
- Dermographism
- Samter’s triad
- Morphine
Morphine is a direct histamine releaser. How do you differentiate between histamine release d/t morphine, and an actual allergic reaction?
If distal to site of injection, then probably allergic rxn
Does contact dermatitis have a wheal and flare rxn?
No–very superficial
What is the role of allergy testing with chronic urticaria?
High false positive rate, and not that useful
true or false: chronic urticaria is a continuous and lifelong disorder
False–episodic and limited
What is the rate of spontaneous remission with chronic urticar at one year?
30-50%
What is the treatment for chronic urticaria?
Oral antihistamines
What is the inheritance pattern of C1 inhibitor deficiency?
AD
What are the s/sx of angioedema?
Swelling of the hands, feet, and GI tract
What is the treatment for angioedema?
FFP +
True or false: angioedema is unresponsive to usual anaphylaxis treatment
True
What is the type of swelling that is had with angioedema
Non pitting
What antiepileptic drug is known for SJS?
Lamotrigine
What are the s/sx of TEN/SJS?
bullous rash with sloughing off of the skin. Respiratory compromise from sloughing off of skin
What is the treatment for TEN/SJS?
Admit to burn unit, and stop meds
