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85 Cards in this Set
- Front
- Back
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What am I:
a chronic skin disorder characterized by itchy, inflamed skin commonly associated with personal or family history of allergic diseases |
atopic dermatitis
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What are the components of the atopic dermititis triad?
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asthma
allergies eczema |
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What is atopic dermatitis also refered to as?
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eczema
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What are the immunologic components that contribute to atopic dermatitis?
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elevated eosinophil and serum IgE
increase susceptibility to bacterial, viral and fungal infections association with other allergic disorders |
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What are the environment components that contribute to atopic dermatitis?
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increase air pollution, industrialization or urbanization
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When does the onset of atopic dermatitis generally occur?
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early infancy
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At what age does atopic dermatitis develop?
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any age
generally before 5 |
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What is the pathophysiology behind atopic dermatitis?
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increase production of IgE
impairment of delayed hypersensitivity response decreased phagocytic capacity impaired chemotaxis of neutrophils and monocytes S. aureus on diseased and normal skin |
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What type of skin lesions are associated with acute atopic dermatitis?
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intense itching
erythematous papules and vesicles |
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What type of skin lesions are associated with subacute atopic dermatitis?
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thicker, paler, scaly, red, excoriated plaques
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What type of skin lesions are associated with chronic atopic dermatitis?
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thickened plaques
lichenoid fibrotic plaques |
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What are the clinical presentation of atopic dermatitis?
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relapsing pruritis and skin reactivity
flares |
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True or False: pruritus worsens through the day in atopic dermatitis
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True
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Where are skin lesions usually located during infancy?
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face
scalp trunk extensor surfaces of extremities |
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Where are skin lesions usually located in older children adn adults with atopic dermatitis?
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in bends of elbow and knees
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What color do lichenoid plaques have?
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vary in color
bright pink-red to brown or gray-brown |
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True or false: lichenoid plaques are well marginated
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False: lichenoid plaques are poorly marginated
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Where do lichenoid plaques normally appear?
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neck
eyelids forehead/scalp anterior chest wrist dorsal areas of fingers, toes and feet |
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What are the 5 risk factors used for diagnosing atopic dermatitis?
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history of flexural dermatitis on face in children younger than 10
history of asthma or allergic rhinitis in child or first-degree relative history of generalized xerosis within the past year visible flexural eczema onset of rash younger than 2 |
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Atopic dermatitis is usually diagnosed by having pruritus plus how many risk factor?
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3 risk factors
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True or False: there is no single test to diagnose atopic dermatitis
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True
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What are some other skin conditions that are similiar to atopic dermatitis?
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allergic contact dermatitis
molluscum contagiosum nummular eczema psoriasis scabies |
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What are the environmental "flare"factors associated with atopic dermatitis?
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xerosis, sweating, exercise, infection, anxiety, scratching, light touch, prickly clothes, soaps/detergents, smoke, temperature changes, allergice contact dermatitis, coexisting diseases, greasy ointments
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Infants who are ________ have a decreased incidence of getting atopic dermatitis
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breasfed
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True or False: there is a weak relationship between food allergies and atopic dermatitis
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False: there is a strong relationship
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animal dander, grass, ragweed, dust mites, and mold are examples of what kind of allergen?
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aeroallergen
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What are the complications associated with atopic dermatitis?
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susceptibility to skin infections
cataracts eyelid dermatitis/blepharitis nipple dermatitis cheilitis (swelling) of lips and surrounding skin |
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True or False: there is no cure for atopic dermatitis
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True
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What are the goals of atopic dermatitis treatment?
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eliminate exacerbating factors
decrease skin inflammation/relieve symptoms prevent recurrent flares |
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What type of wet dressing can aid in drying out the oozing lesion?
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tepid compresses
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What type of wet dressing will cool and dry stimulating vasoconstriction?
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burow solution (aluminum acetate) 1/20
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What topical products can be used to treat atopic dermatitis?
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corticosteroids
immunosuppressants tar preparations topical antibacterial agents phototherapy |
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What systemic products can be used to treat atopic dermatitis?
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antihistamines
antimicrobials corticosteroids cyclosporine azathioprine antimetabolites interferon |
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What type of corticosteroids should not be used for longer than 3 weeks to treat atopic dermatitis?
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high-potency steroids
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What ares of the skin should be avoided when using high potency corticosteroids?
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face, skin folds, mucous membranes
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What type of topical corticosteroids are betamethasone cream/ointment and triamcinolone cream/ointment
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high-potency
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What type of topical corticosteroids are used for chronic atopic dermatitis?
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moderate strength
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Where are moderate strength topical corticosterodis typically applied?
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on trunk or extremities
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What type of topical corticosteroids are betamethasone lotion, mometasone and triamcinolone?
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moderate strength
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What type of topical corticosteroids are typically used in children?
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low-potency
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What type of topical corticosteroid are desonide cream and hydrocortisone?
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low potency
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What type of vehicle can increase percutaneous absorption?
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occlusives
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What is stonger?
creams ointments lotions |
ointments > creams > lotions
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When should moisurizers be applied when using topical corticosteroids?
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apply corticosteroid first, then apply moisturizer
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What is the adverse effects of long-term corticosteroid use?
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skin atrophy, striae, hypopigmentation and steroid induced acne
growth retardation in children |
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What drug am I:
topical treatment used for atopic dermatitis Form a complex that results in the inhibition of calcineurin inhibits T-cell, mast cell, and dendtritic cell activation |
calcineurin inhibitors
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What are the topical calcineurin inhibitors?
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tacrolimus (protopic)
pimecrolimus (Elidel) |
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What am I:
topical calcineurin inhibitor used for the treatment of moderate to severe atopic dermatitis in adults not responding to other therapies |
tacrolimus 0.1% ointment
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What am I:
topical calcineurin inhibitor used to treat moderate to severe atopic dermatitis in children older than 2 |
tacrolimus 0.03% ointment
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What am I:
topical calcineurin inhibitor used to treat mild to moderate atopic dermatitis in children (as young as 3 months) and adults |
pimecrolimus 1%
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How many times daily should topical calcineurin inhibitors be applied?
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BID
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True or False: topical calcineurin inhibitors can be used for longer term
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True
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How long does it take for patients to respond to topical calcineurin inhibitor?
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3 days
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What is the most frequent ADR of topical calcineurin inhibitors?
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local burning
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What is the ADR of long term use of topical calcineurin inhibitor?
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actinic keratosis
viral warts nonmelanoma skin CA |
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Which of the topical agents used for atopic dermatitis have a black box warning?
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topical immunosuppressants
topical calcineurin inhibitor |
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True or False: topical immunosuppressants are approved for short term and intermittent periods only
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True
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What drug am I:
have antipruritc and antiinflammatory effects reduce the need for topical corticosteroids may stain clothing |
tar preparations
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What type of lesions should tar preparations be avoided in?
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inflamed and oozing lesion
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When are topical antibacterial agents used for atopic dermatitis?
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when atopic dermatitis is secondary to skin infections
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erythromycin, bacitracin, and mupirocin are what type of agents used for atopic dermatitis?
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topical antibacterial agents
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This type of phototherapy is useful as an adjunctive treatment for chronic atopic dermatitis
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UVB
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This type of phototherapy can be therapuetic in acute exacerbations of atopic dermatitis
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UVA (higher intensity)
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This type of phototherapy is used for severe widespread atopic dermatitis
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methoxypsoralen + UVA (PUVA)
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What are the ADRs of phototherapy?
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erythema
pruritus skin pain pigmentation changes premature skin aging and malignancies |
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Acyclovir and valcyclovir are used to treat atopic dermatitis secondary to what disease?
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herpes
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How is prednisone used in the treatment of atopic dermatitis
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short term for acute flares associated with atopic dermatitis
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What drug am I:
inhibit T-lymphocyte-dependent immune responses and down regulate cytokine production FDA approved for psoriasis |
cyclosporine
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How is cyclosporine used in the treatment of atopic dermatitis?
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short term for severe refractory disease
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What are the adverse effects of cyclosporine?
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renal toxicity
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What are the monitoring parameters of cyclosporine use?
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electorlytes
renal fuctions CBC fasting lipid profile uric acid levels drug-drug interactions |
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What drug am I:
purine analog systemic immunosuppressant |
azathioprine
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What type of atopic dermatitis is azathioprine used for?
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severe
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How long does it take to see the effects of azathioprine in the treatment of atopic dermatits?
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4-6 weeks
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What are the adverse effects of azathioprine?
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hepatoxicity
GI disturbances myelosuppression |
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What drug am I:
immunosuppressant used in organ transplant effective in atopic dermatitis resistant to ther treatment |
mycophenolate mofetil
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When should mycophenolate mofetil be discontinued?
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if patient does not respond in 4-8 weeks
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What drug am I:
antimetabolite; folic acid antagonist used in psoriasis |
methotrexate
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What are the adverse effectrs of methotrexate?
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myelosuppression
hepatotoxicity folic acid difiency |
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At what dose is methotrexate effective for atopic dermatitis?
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2.5mg QIW
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What drug am I:
inhibit TH2 cells suppresses IgE response to atopic dermatitis |
interferon
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What are the adverse effects of interferon?
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flu-like symptons
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What type of therapy am I:
breaks the cycle of scratching involves: complete bed rest semi darkened room for a few days light sedation short course oral corticosteroid antibiotic if needed sedating antihistamine |
simulated hospitalization
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What type of therapy am I:
biofeedback, relaxation training, and learning to properly express anger and be assertive |
behavioral and cognitive intervention
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What type of therapy am I:
invovles: topical application of evening primrose oil or borage oil reduced rate of conversion of linoleic acid to GLA, dihomo-GLA and arachidonic acid present in some patients with AD |
GLA-gamma-linolenic acid
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