Atopic Dermatitis

Question 1

what is atopic dermatitis?

eczema

Answer 1

very common condition that typically starts in childhood

Question 2

what is the common cutaneous characteristics of atopic dermatitis?

Answer 2

• dry skin
• flares of erythematous, poorly demarcated patches
• itchy
• infants = commonly affects cheeks (nappy area spared)
• children/adults = flexure surfaces

Question 3

what is the NICE criteria for diagnosing atopic dermatitis?

Answer 3

itchy skin + 3/5 of:
* visible flexural eczema
* history of flexural eczema
* history of dry skin
* history of asthma or allergic rhinitis
* onset <2 years old OR on the cheeks/extensors in children <18 months

Question 4

what are the complications of atopic dermatitis?

Answer 4

• eczema herpeticum
• superficial bacterial infection
• erythroderma

Question 5

what is eczema herpeticum?

Answer 5

dermatological emergency
* caused by disseminated HSV infection due to impaired skin protection
* monomorphic vesicular rash (can ulcerate and crust)
* systemic effects - e.g. fever

Question 6

how is eczema herpeticum diagnosed?

Answer 6

swab + Tzanck test

Question 7

how is eczema herpeticum managed?

Answer 7

IV aciclovir

Question 8

what is erythroderma?

Answer 8

dermatological emergency
* widespread erythema affected >90% of skin surface
* heat and fluid loss –> hypothermia + systemic symptoms

Question 9

what are the side-effects of topical corticosteroid use?

Answer 9

• skin thinning
• striae
• telangiectasia

Question 10

what is the pathophysiology of atopic dermatitis?

Answer 10

genetic defect in the skin barrier
causes loss of function of the protein filaggrin