Basics of Eczema & Atopic Dermatitis PDF

Block 1.2 lectures 2024-2025 lecture Highlighter key Writer Reviewer Doctor...

Block 1.2 lectures 2024-2025 lecture Highlighter key Writer Reviewer Doctor explanation Abbreviation Key information Book >> >> Abdulrahman Furat Al-Mutawa Albousaif Student explaintion 221-222-223 notes References Deleted Atopic Dermatitis Dr. Heba yousef Al-ojail  This is an image of a child with atopic dermatitis “The most common skin lesion in children is atopic dermatitis.” “‫ على الوجه‬Skin lesion‫”دائما كل ما صغر بالعمر تجيهم ال‬ “Flexure site‫ على ال‬Skin lesions‫”كل ما كبروا بالعمر تكون ال‬ Area of sparing “unaffected area” near the nose and lower lip  This is an image of atopic dermatitis on a flexure site “‫ على الوجه‬Skin lesion‫”دائما كل ما صغر بالعمر تجيهم ال‬ “Flexure site‫ على ال‬Skin lesions‫”كل ما كبروا بالعمر تكون ال‬ Flexure site = The parts of the body that are able to flex. The backs of the knees, the insides of the armpits, elbows and groin. ❛ Eczema is a clinical term that embraces a number of conditions with varied underlying etiologies. Erythema = ‫إحمرار‬ New lesions take the form of erythematous papules, often with overlying vesicles, which ooze and become crusted. Pruritus is characteristic. Pruritus = itchy skin With persistence, these lesions coalesce into raised, scaling plaques. The nature and degree of these changes vary among the clinical subtypes, which include the following: Atopic dermatitis—formerly attributed to allergen exposure, now thought to often stem from defects in keratinocyte barrier function, defined as skin with increased permeability to substances to which it is exposed, such as potential antigens “nearly most types of medication could lead to allergic dermatitis or even sometimes atopic dermatitis” Allergic contact dermatitis. Drug-related eczematous dermatitis—hypersensitivity reaction to a drug Photoeczematous dermatitis—appears as an abnormal reaction to UV or visible light “any sun exposure is called as “photo” or “solar” Primary irritant dermatitis—results from exposure to substances that chemically, physically, or mechanically damage the skin. Endogenous Eczema Endogenous = having an internal cause or origin. Atopic = the genetic predisposition to develop an allergic reaction that produces an exaggerated IgE response when a person is exposed to otherwise harmless environmental substances. reflects a genetic predisposition and can persist for years or decades, other forms of eczematous dermatitis resolve completely when the offending stimulus is removed or exposure is limited, stressing the importance of investigating the underlying cause.  Susceptibility to atopic dermatitis is often inherited; the disorder is concordant in 80% of identical twins and 20% of fraternal twins. It usually appears in early childhood and remits spontaneously as patients mature into adults. Children with atopic dermatitis often have asthma and allergic rhinitis, termed the atopic triad. Recent genetic studies have identified polymorphisms associated with increased risk in genes that encode proteins involved in keratinocyte barrier function, innate immunity, and T cell function. “in most cases atopic dermatitis can have a genetic disposition” “‫ لين ما تتخرجون فاعرفوها من الان‬allergic triad‫راح تسمعون مصطلح‬ ‫”ال‬ Bronchial asthma = a chronic lung disease caused by inflammation and muscle tightening around the airways, making it harder to breathe. Atopic dermatitis = a chronic disease that causes inflammation, redness, and irritation of the skin Allergic rhinitis (Hay fever) = irritation of the nose by something you're allergic to, causing sneezing, a runny or blocked nose and itchy red and watery eyes “‫ هذي دائما تجي مع بعض‬.‫”هذي احفظوها‬  ‫ اذا فهمتوها من اول مرة صدقوني راح يكون الطب سهل عليكم بإذن‬.Pathogenesis‫“خلوها طبع فيكم الين ما تتخرجون انكم تفهمون ال‬ Pathogenesis ”‫الله‬ “The filaggrin mutation and decreased ceramide will lead to 1-Dryness ? increased water loss and will therefore lead to dryness” Filaggrin (filament aggregating protein) is a filament-associated protein that binds to keratin increase Water loss; 1- Filaggrin mutation. 2- ceramide fibers in epithelial cells. Filaggrin is essential for the regulation of epidermal homeostasis. interluekins 4, 5 and 13 ‫“انتوا على الأقل اعرفوا ان عندنا‬ 2-Inflammation; ”which will lead to inflammation Ceramides are fats or lipids that are found in skin cells. Ceramides are important for retaining your skin’s moisture and preventing the entry of germs -IgE inflammatory process. IL4.,5,13. into your body.. 3- itching “The itching is caused by the release of histamine”  “When diagnosing atopic dermatitis it is a clinical diagnosis “‫ ”من الصورة‬but sometimes we request a blood test” Dx = Diagnosis CBC = complete blood count EOS = eosinophil Clinical Dx. CBC; eos. ‫ دائما‬allergic or parasitic infection ‫ دائمًا اختاروا “حطوها في بالكم اي شي فيه‬allergy‫ وال‬parasite‫“فلو يجيكم سؤال فيه علاقة بال‬ ”immunoglobulin E‫ وال‬eosinophils‫يزيد عندهم ال‬ ”IgE‫ وال‬eosinophil‫ال‬ IgE. Prick Test. Skin biopsy.  Microscopically, there is accumulation of fluid (spongiosis) between epidermal cells, which may progress to frank blister formation. Spongiosis, or epidermal edema, characterizes all forms of acute eczematous dermatitis—hence the synonym spongiotic dermatitis.  “This is chronic eczema” Erythema = ‫إحمرار‬ Pruritus = itchy skin Vesiculation = ‫تكون البثور‬ Lichenification = ‫التشجر‬  Lichenification = ‫التشجر‬ Erythema = ‫الإحمرار‬  ‫ بس‬location‫“عشان نعرف ال‬ atopic dermatitis‫احفظوا لي ان‬ ‫ وفي‬over the flexure site ”any site ‫الأطفال بتكون في‬ ‫“كل ما كبر الطفل بالعمر كل ما‬ eczema more‫كانت ال‬ ”localized ‫ او‬،eyelids‫“ممكن تكون في ال‬ ”leg‫ او ال‬hands‫ال‬ “but the most common prototype in atopic dermatitis is the flexure site” Search for underlying Cause and if possible Treat/avoid/ Exacerbating factor Topical steroids are the topical forms of corticosteroids. Topical steroids have anti-inflammatory Topical steroids. properties and are classified based on their skin vasoconstrictive abilities. Antibiotics could be prescribed as patients with atopic dermatitis are susceptible to skin infections because Antibiotics. of the disruption of the epidermis. Ninety percent of patients with atopic dermatitis are colonized with S. aureus, which increases their risk of cutaneous infections. As histamine increases the vascular permeability of blood vessels, it causes fluid to escape from capillaries Antihistamines. into tissues, which leads to the classic symptoms of an allergic reaction like a runny nose and watery eyes. Antihistamines suppress the histamine-induced swelling and flare response vasodilation by blocking the binding of histamine to its receptors or reducing histamine receptor activity Wet compresses. Wet compresses can hydrate the skin, relieve the irritating itch of eczema and prevent scratching. Also, Covering the skin helps topical moisturizers and medications to penetrate the skin and prevent them from evaporating.  team Wishes you the best