atopic dermatitis

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Author:
alvo2234
ID:
259165
Filename:
atopic dermatitis
Updated:
2014-01-29 21:14:59
Tags:
dr cheung
Folders:
pt VII
Description:
exam 1
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  1. what are the 3 types of skin lesions
    • acute 
    • subacute 
    • chronic
  2. describe the acute phase
    intensely pruritic, erythematous papules and vesicles
  3. describe the subacute phase
    thicker, paler, scaley, erythematous and excoriated plaques
  4. describe the chronic phase
    thickened plaques, accentuated skin markings, and fibrotic papules
  5. where are the locations of skin lesions with AD
    • extensor surfaces of the extremities:
    • trunk
    • face
    • scalp
    • neck
  6. atopic skin is associated with what
    xerosis
  7. how is AD diagnosed
    • with the presence of pruritus and >= 3 of:
    • Hx of dermatitis of face in children < 10
    • Hx of asthma or allergic rhinitis
    • Hx of generalized xerosis within past yr
    • visible flexural eczema
    • onset of rash younger than 2yrs of age
  8. what is the standard tx for short term treatment and intermittent use of AD
    topical corticosteroids
  9. potency of topical corticosteroids are determined by what
    • penetration of skin 
    • intrinsic activity at the receptor
    • rate of clearance from the receptor
  10. how is corticosteroid activity enhanced
    • using an occlusive vehicle
    • using penetration-enhancing substances
    • modification of the steroid molecule
  11. what type of CCS should be used in the groin, face, axillae
    • low potency 
    • non flourinated
    • ex., hydrocortisone
  12. topical immunomodulator used for mod to severe AD
    tacrolimus (Protopic)
  13. % strength of tacrolimus used to treat adults and children
    • .03 to .1% for adults
    • .03 for children 2 to 15 yrs
  14. topical immunomodulator use to treat mild to moderate AD
    pimecrolimus (elidel) 1% cream
  15. what is the FDA box warning for topical calcineurin inhibitors
    lymphoma and skin malignancies; should be used for short-term and intermittent treatment.
  16. agents used as adjunctive therapy to treat AD
    antihistamines; used for sedation at night and pruritus.

    astringents (coal tar, liquor carbonis detergens); contain anti inflm and pruritic effects
  17. which antihistamines can be used for AD
    • hydroxizine
    • cyproheptadine
    • doxepin (TCA)
    • cetirizine
  18. when should coal tar preparations not be used
    on acute oozing lesions
  19. when should coal tar be used
    at bedtime and rinsed off in the morning
  20. what agents should be used for the treatment of severe refractory AD
    • phototherapy
    • potent topical CCS
    • systemic immunosuppresants (MTX, cyclosporine, oral CCS, azathioprine)
  21. what are the selective topical antibiotics that can be used for AD
    • bacitracin
    • mupirocin
    • gentamicin, neomycin, polymixin B
  22. bacitracin works well agains which organism
    all anaerobic cocci and gram + cocci
  23. mupirocin works well agains which organisms
    • MSSA
    • MRSA
    • strep
  24. gentamycin, neomycin, polymyxin B work well agains which organisms
    most gram -

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