Atopic dermatitis

From greek.doctor
  • Affects 10% of children, but only 1 – 3% of adults
  • Associated with other atopic diseases
    • Asthma
    • Allergic rhinitis
  • Etiology
    • Polygenic inheritance
    • Environmental riggers
      • Dust
      • Heat
      • Infection
      • Skin irritation
  • Pathophysiology
    • Epidermal skin barrier defect
      • -> water loss
      • -> allergens can penetrate barrier
    • Abnormal immune response
  • Clinical features
    • Morphology
      • Acute
        • Erythematous maculopapular rash
        • Dry plaques
        • Oedema
      • Chronic
        • Lichenification
        • Scaling
        • Fissures
    • Mostly on flexor surfaces
      • Except in infants
    • Pruritus
    • Dry skin
    • Cheilitis
  • Diagnosis
    • Clinical
    • Serum IgE elevated
    • Serum LDH elevated
  • Complications
    • Staph infection
    • Eczema herpeticum
    • Tinea
  • Treatment
    • Emollients
    • Topical corticosteroids
      • Mometasone
      • Clobetasol
    • Topical calcineurin inhibitors
      • Tacrolimus
    • Oral antihistamines
    • Oral immunosuppressive therapy
      • Corticosteroids
      • Cyclosporine
    • Biological treatment
      • Anti-IL-4 – dupilumab
      • Anti-IL-5 – mepolizumab
      • Anti-IL-31 – prevents itching
      • Anti-TSLP