The Eczemas Flashcards
What is the atopic triad?
asthma, allergic rhinitis, and AD
What is the typical age of onset of AD?
6 months or younger
What are the signs and symptoms of AD?
Pruritus (itching)
Dry, scaly skin
Crusted rashes on face, scalp, hands, arms feet or legs
Small bumps that open and weep when scratched
Redness and swelling of the skin
Thickening of the skin (with chronic dermatitis)
Also:
more acute in infancy and involves face, scalp and extensor surfaces of extremities
In adults, usually chronic form with lichenification and localization to flexural extremities
In dark-skinned individuals, post-inflammatory hyperpigmentation develops
Increased susceptibility to Staphyloccoccal infections due to decreased antimicrobial peptides
What are associated features of AD?
i. Ichthyosis vulgaris
ii. X linked ichthyosis
iii. Dennie Morgan folds-under eye folds
iv. Hertoghe’s Sign –lateral loss of 1/3 of eyebrow
v. Hyperlinearity of palms
vi. opthalmological conds: cataracts
What are skin diseases related to atopic dermatitis?
a. Eczema Herpeticum
b. Eczema Vaccinatum
c. Staphyloccoccus Infection
d. Molluscum Contagiosum – by pox virus
e. Keratosis Pilaris
f. Pityriasis Alba –post inflammatory hypopigmentation
g. Seborrheic dermatitis –forehead and behind ears
Understand the immunology of atopic dermatitis.
- IgE production is high
- Th2 profile
- Decreased level of defensins and cathelicidins (anti microbials)
- gene defect in filaggrin
- low levels of FFAs, ceramics, cholesterol
- barrier abnormalities make skin more permeable to irritants, allergens, microorganisms
How is AD diagnosed?
With 3 or more of both major and minor criteria.
Major:
i. Pruritus
ii. Lichenification
iii. Chronic or chronically relapsing course
iv. Personal or family history of atopy
What is the treatment strategy for AD?
- Avoid Triggers
- Control Dry Skin
- Treat inflammation
What is irritant contact dermatitis?
- most common occupational skin disease
- occurs when normal barrier disrupted and secondary inflammation develops
- non immunological
What are some types of irritant contact dermatitis?
- water
- skin cleansers
- acids and alkalis
- oils and organic solvents
- plants
- animal products
- industrial cleaning agents
What type of immunological response is allergic contact dermatitis?
-Th1 response, Type IV cell mediated delayed hypersensitivity reaction
What are the most common causes of ACD?
Latex/rubber Poison ivy/oak/sumac Ni/Au Balsam of Peru Neomycin/Bacitracin Fragrance Thimerosal Formaldehyde and formaldehyde-realeasing preservatives
How is ACD diagnosed?
patch testing
