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85 Cards in this Set

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