medicine 6th year, dermatology tutorial (5th session/part two)
DESCRIPTION
September 5th, 2011TRANSCRIPT
Atopic DermatitisAtopic Dermatitis
AD: ICCAD II
• AD is a common chronic relapsing inflammatory skin disease characterized by:
Intense itching.
Dry skin.
Inflammation.
Exudation.
Physical & emotional distress for pts. and their families.
- > psoriasis.
- = early onset of DM.
AD: ICCAD II (Cont’d)
• Early age of onset:
50% of cases diagnosed by 1 year of age.
1/3 of patients having persistent disease throughout adulthood.
• Vast majority of cases are mild.
AD: ICCAD II (Cont’d)
• AD is often familial and frequently associated
with asthma, food allergy, allergic rhinitis
and recurrent 2ry skin infections.
• AD may increase subsequent risk or severity
of asthma.
AD: ICCAD II (Cont’d)
• Trigger factors:
• Increased prevalence: 10-15% of children
(<yrs) are affected.
Stress.
Irritants.
Microbes, and
Allergens.
III-DiagnosisIII-Diagnosis
Atopic DermatitisAtopic Dermatitis
AD: Clinical features
Infantile phase (2 months – 2 years)
• Cheeks, forehead and body but sparing the diaper
area.
• Erythema, itchy edematous papules with rubbing
exudative & crusted.
• 2ry infection and lymphadenopathy.
AD: Clinical features (Cont’d)
Childhood phase (2 – 12 years)
• Elbow and knee flexures, sides of neck and
hand.
• Itchy papules and lichenified plaques.
Scratching lichenification.
AD: Clinical features (Cont’d)
Adult phase (? atopic neurodermatitis)
• As childhood phase with lichenification of
flexures.
• Hand dermatitis, upper eyelid dermatitis.
• Dry skin and keratosis pilaris.
Hanifin & Rajak’s diagnostic criteria for
AD (1980)
Major criteria
• Adults: flexural lichenification or linearity.
• Children and infants: facial, extensor.
1. Pruritus.
2. Typical morphology and distribution
3. Chronic or relapsing dermatitis.
4. Personal or family history of atopy.
Hanifin & Rajak’s diagnostic criteria for AD (Cont’d)
Minor criteria
1. Xerosis.
2. Ichythosis, keratosis pilaris, palmar hyperlinearity.
3. Type I skin test reactivitiy.
4. Elevated serum IgE.
5. Early age at onset.
6. Tendency to skin infections.
7. Infraorbital darkening and linearity.
8. Atypical vascular responses.