Intoductory Sanofi Flashcards
What is a full definition of Atopic Dermatitis?
Chronic, inherited, inflammatory skin condition characterised by dry, itchy, reddened skin.
… a chronic, pruritic, systemic inflammatory skin disease that is associated with
immune dysregulation and
skin barrier dysfunction.
Eczema is umbrella, with AD being one syndrome.
No cure. Patterns of Relapse(Flaring) and Remission. Atopic ‘march’
What inflammatory triggers are there? And what two ways do they get involved?
Triggers to AD can be:
Allergens- cigarette smoke, dust mites, pollen, mould, soap, perfume, .
Weather
Stress
Uncertain if they either trigger or they worsen the inflammation.
What regions of the body have AD involvement?
Flexor Surfaces - create of wrists, inside of elbows, backs of knees
Exposed Skin Surfaces- face, hands, feet
Why do we call it an inflammatory mediated cycle rather than a process?
Inflammation —> Itching—> Scratching—> Inflammation
Draw out the 10 step underlying cycle to Dryness, Scaliness and Itchiness.
Allergen —>APC-Naive Th —> Th2 that stimulates BBBB cells to generate IgE antibodies Dow ific for allergan.
IgEs ABs Stick to Mast & Basophils= sensitisation.
Upon re-triggering, Degranulisation,
pouring out Histamines, Leukotrienes and Proteases.
->->Blood Vessel Dilation = fluid loss/dryness
= flooding of immune cells /itching
From itchy To Blister and Peel To Lichenified !
Treatment Goals?
A. Underlying Inflamm - identify and avoid triggers like over-heating/ wear soft fabrics/lower all stressors/ meds that dampen.
B. Dry Skin -moisturisers
C. Itch Scratch - minimise, from nails, Antihistamines
What does ‘blister and peeling’ practically look like?
“ Cracked hands, Bleeding, Pain and Dry Hands”
“The itching just drives me absolutely nuts…constantly feeling my skin tear underneath… help me get rid of this itch !”
Differentiate the chronic form from the acute form.
Acute: red, scaly and/or weeping from scratching small vesicles
Chronic : beyond mild scaling and lichenification to prominent forms.
Excoriation signs in all stages.
Chronic lesions - epidermal hyperplasia, prominent hyperkeratosis, minimal spongiosis
Patient descriptions of Itchy syndrome, Cuts…
I’d say the ITCH just drives me absolutely NUTS… Help me get rid of the itch.
It is Excruciating. It’s Irritating. It’s Constant
I felt my skin tear underneath and still I have not wanted to stop.
Like a Paper Cut… For me it is like a Million paper cuts on my hand everyday!
You can’t bend them… cutting sone meat on your plate, your knuckles are bleeding!
(Rubbing hand)… sounds like…hideous!
Very tight here (near bicep) , and scarring… my legs are quite bad.
It’s Exhausting. It’s Vicious. It’s Lonely. It’s robbed me.
Some days I get angry. I get frustrated and I get Depressed.
“I still wake up in a panic, struggling to catch my breath after I’ve relived those days in my dreams,”
“My face and body was constantly raw and weeping, so I withdrew from the world,”
Why is it considered a complex aetiology ?
Immune Dysregulation + Skin Barrier Dysfunction + Genetic source.
