Introduction to Dermatology, Urticaria and Angioedema - PDF

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

Block 1.2 lectures 2024-2025 lecture Highlighter key Writer Reviewer >> >> Abdulaziz Ali Doctor explanation Abbreviation Key information Book Abdullah Mortada Alessa Alkhars 221-222-223 notes References Student explaintion Deleted URTICARIA & ANGIOEDEMA Dr.Heba Yousef Al-ojail  Swelling Redness Itching [ Last for less than 24 hours, more than that is another diagnosis ] 💡 The doctor said: You can remember the symptoms by remembering “what happens if a Mosquito bites you ?”  Shortness of breath Angioedema: A swelling in mucous Swelling of Patient’s: Eyelids, Lips membrane and somtimes genital organs 🤔 Why we mention Urticaria with Angioedema ? Because they come together, Always a patient who has Urticaria must has Angioedema This is the bite of Mosquito >>> Patients with Urticaria and Angioedema develop Mosquito bite symptoms: Swelling Redness Itching [ Last for less than 24 hours ] without being bitten  Urticaria = Hives = ‫الشرى‬ Urticaria (Hives) 👍 Just different terms Skin reaction due the release of inflammatory mediators in the body – mainly histamine Histamine – leads to itching, vasodilation and fluid leakage – so produces red/raised skin lesions –’Wheals’ Usually a Type 1 immediate hypersensitivity reaction to external triggers like food, insects etc. The doctor said memorize the highlighted only 💯 Usually: Acute: Less than 6 weeks chronic: More than 6 weeks 🤔 What is the most commonly associated symptom to urticaria? Angioedema, 40% of patients who have urticaria have Angioedema as well  This well help you in HISTORY TAKING 🤒📝 🟢 The doctor said : “ ,‫بتساعدكم حاليا و في سنة رابعة‬ ‫”اقرأوها و مروا عليها‬  Most common causes of Acute Urticaria : Infections Ingestion stress Drugs & Medications Sometimes Tooth decay lead to Urticaria Most common causes of Chronic Urticaria , are many, such as: Autoimmune diseases Hepatic diseases  🔴 The doctor said : This is very important table “ ‫”احفظوه‬  Sometimes Chronic Urticaria Acute & Chronic caused by Cold Water exposure which is COLD URTICARIA Sometimes Chronic Urticaria caused by Hot Water exposure Some people have AQUAGENIC which is HEAT URTICARIA URTICARIA, due to Water exposure The doctor mentioned the highlighted🤝  Heat Urticaria Pressure Urticaria Cold Urticaria Aquagenic Urticaria The physician is the one who caused this XO structure, but why? The physician used DERMOGRAPHISM Test “ ‫“ الكتابة على الجلد‬ The physician took a hard object and press on the Patient’s skin for almost 1 minute and induce Urticaria This will help the physician to reach the diagnosis The doctor didn’t stop on this slide The doctor didn’t stop on this slide  This is how Angioedema looks like If a patient come to the clinic with: Urticaria + Angioedema + Shortness in breath = He has Anaphylaxis After asking the patient about: if he has shortness of breath palpitation GI symptoms and make sure that he has Anaphylaxis The treatment is: Epinephrine Anaphylaxis Epinephrine  Angioedema When urticarial reactions occur in areas with loose skin (less subcutaneous tissue) edema tends to be more severe  Angioedema may present without Urticaria Hereditary Angioedema is an Autosomal Dominant that has 3 types: Type 1️⃣ : C1 Esterase inhibitor deficiency ( C1 Esterase is not present ) 🤔 A patient with swelling in Eyelids without skin itching and without shortness of breath - Only Angioedema Type 2️⃣ : C1 Esterase is present BUT not functional = He has a type of Hereditary Angioedema Type 3️⃣ : Related to coagulation factors ( Treatment Factor ) The doctor said it is importnat to know the types, because she may ask in the exam about: THE MOST IMPORTANT PARAMETER IN EACH TYPE?  C4: Type 1 & 2 : ‫ناقص في‬ Type 3 : ‫ في‬Normal C2: Angioedema Attack ‫ينقص اثناء الـ‬ C1q: Acquired Angioedema ‫ينقص في الـ‬ 🔴 The doctor said this slide is important for the exam  How do we differentiate between Hereditary & Acquired Angioedema ? Hereditary: Most likely affects children Also, people who have: - History of sudden death, Why? Usually people with history of sudden death show Anaphylaxis in ER, they have swelling in Pharynx & Larynx + Shortness in breath, and they will pass away Acquired : Most likely affects Elder people, who have for example: - History of cancer - Loss of Appetite - Loss weight Treatment for urticaria and angioedema There are: Pharamacological & Non-Pharmacological Treatments Try to find underlying cause We should know the causes of Angioedema to tell the patient to avoid it PRICK TEST Avoid/remove triggers 🔴 The most important treatment is: Antihistamines which we give it Orally Antihistamines Severe cases systemic steroids 🟢 Sometimes we give : systemic steroids which we give it topically The doctor mentioned the highlighted 🤝 Anaphylaxis Severe allergic reaction – extensive release of chemical mediators like histamine Vasodilation – low blood pressure- shock Bronchospasm – respiratory distress Medical emergency Treatment for anaphylaxis 🚑 Anaphylaxis patients must take Epinephrine as soon as possible Emergency Drug of choice – Epinephrine Epinephrine is the ‘physiological antagonist’ of histamine Epinephrine People with Anaphylaxis wear a Bracelet shows there allergy + They have Epinephrine Pen in their bags  A 66 years old man come to your clinic, with eyelids and lips swelling , after history taking you found that the man lost 12kg recently due to loss of appetite, What is his most likely diagnosis? A- Acquired Angioedema B- Hereditary Angioedema C- Eczema D- Malaria  A 66 years old man come to your clinic, with eyelids and lips swelling , after history taking you found that the man lost 12kg recently due to loss of appetite, What is his most likely diagnosis? A- Acquired Angioedema ✅ B- Hereditary Angioedema C- Eczema D- Malaria Slide 23  team Wishes you the best