Chapter 5: Atopic Dermatitis Flashcards
(42 cards)
What is atopy?
Designates a group of patients who had a personal or family history of one or more of the following diseases: hay fever, asthma, very dry skin, and eczema
What are the major criteria of atopic dermatitis
Must have three or more
Pruritus Typical morphology and distribution flexural lichenification in adults facial and extensor involvement in infants and children dermatitis personal or family history of atopy
What affect does IgE have on patients with atopic dermatitis
Serum levels of many patients are increased, but 20% of atopic dermatitis patients have normal serum IgE
What is chronic dermatitis
The result of scratching over an extended period, resulting in the thickened skin, accentuated skin markings (lichenification), and fibrotic papules
What are the three phases of atopic dermatitis
- Birth to two
- Childhood
- Adult
Discuss the infant phase (birth to two years) of atopic dermatitis
Typically develops the first signs of inflammation during the third month of life.
Inflammation spares the perioral and paranasal areas
How does atopic eczema affect growth in kiddos
The growth in children with eczema affecting less than 50% of the skin surface area appears to be normal, and impaired growth is confined to those with more extensive disease.
Discuss childhood phase (2 to 12 years) of atopic dermatitis
Most common in characteristic appearance of atopic dermatitis is inflammation in the flexural areas
The active perspiring stimulates burning and intense itching and initiates the itch-scratched
What affect will constant scratching have with atopic dermatitis
Constant scratching may lead to destruction of melanocytes, resulting in areas of hypo pigmentation that become more obvious when the inflammation subsides.
What is the adult phase (12 years to adult) of atopic dermatitis
Begins to the onset of puberty.
May have no history of dermatitis.
- Hand dermatitis
- inflammation around the eyes
- the lichenificationof the anogenital area
What soaps are safe to use with dry skin
Dove
Cetaphil
What is ichthyosis vulgaris
A disorder of keratinization characterized by the development of dry, scales
What is dominant ichthyosis vulgaris
White translucent quadrangular scales on the extensor aspect of your arms and legs.
This form is significantly associated with atopy
Who is affected by sex-linked ichthyosis vulgaris
affects only males
Scales are smaller and lighter in color than the large, brown polygonal scales of sex linked ichthyosis vulgaris
This condition tends to improve with age. Application of 12% ammonium lactate lotion or cream or urea cream is very effective
What is keratosis pilaris
Very common it seems to occur more often and more extensively in patients with AD
The posterior lateral aspects of the upper arms and anterior thighs are frequently involved, but any area, with the exception of the palms and soles, may be involved.
Most cases are asymptomatic, but lesions may be red, inflammatory, and pustular and resemble bacterial folliculitis, particularly on the thighs.
What are hyper- linear palmer creases
Atopic patients are frequently found to have in accentuation of the major skin creases of the palms.
This accentuation may be present in infancy and become more prominent as age and severity of skin inflammation temperature
What is pityriasis alba
A common disorder that is characterized by an asymptomatic, hypopigmented, slightly elevated, fine, scaling plaque with indistinct borders
The loss of pigment is not permanent as it is in vitiligo
Tinea versicolor is rarely located on the face, and the hypopigmented areas or more numerous and more confluent.
What is atopic pleats
The appearance of an extra line on the lower eyelid (Denny-Morgan infraorbital fold)
an unreliable sign of the atopic state
What are some triggering factors for atopic patients
- Temperature change and sweating.
- Decreased humidity
- Excessive washing
- Contact with irritating substances.
- Contact allergy.
- Aero allergens
How does cigarette smoking affect atopic dermatitis?
Smoke may provoke eczematous lesions on the eyelids. The inflammation is frequently interpreted as an allergic reaction by patients who claim they are allergic to almost everything they touch.
How is treatment handled for atopic dermatitis
Treatment goals consists of attempting to eliminate inflammation and infection, preserving and restoring the stratum corneum barrier by using emollients, using anti-pruritic agents to reduce the self-inflicted damaged and controlling exacerbating factors.
How should patients bathe with atopic dermatitis
Bathing hydrates the skin, when moisturizer is applied immediately after bathing before the water has a chance to evaporate (within three minutes), thus retaining the hydration keeping the skin soft and flexible
How is acute inflammation treated with atopic dermatitis
Topical steroids for rapid control and then switching to pimecrolimus or tacrolimus to complete treatment
What level of steroids should be initiated for treatment of atopic dermatitis in adults
use mid-strength to high-strength (adults) steroids as initial treatment.
Limit treatment to two weeks
Ointment-based medications are preferred for dry skin
Introduce patients to pimecrolimus cream (Elidel) or tacrolimus ointment (Protopic)
