Location signs 2 months chest face red raised

Location Signs
2 months Chest, face Red, raised vesicles;
dry skin; oozing
2 years Scalp, neck and
extensor surface of
extremities
Less acute lesions;
edema; erythema
2 – 4 years Neck, wrist, elbow, knee Dry, thickened plaques;
hyperpigmentation
12 – 20 years Flexors, hands Dry, thickened plaques;
hyperpigmentation
Diagnosis of AD

Itchy skin condition + 3 or more of the
following:

Onset at <2 yo

History of skin crease involvement

Cheeks, neck, eyes, ankles

Personal history of other atopic disease

History of generally dry skin

Visible flexural dermatitis

Elbows

Behind knees

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5
Atopic Dermatitis Pathophysiology

Intense itch-scratch cycle

3 types of skin lesions

Acute: pruritic, erythematous papules and vesicles

Subacute: thick, pale, scaly, excoriated plaques

Chronic: thickened plaques, accentuated skin
markings and fibrotic papules
Exacerbating Factors

Soaps

Detergents

Chemicals

Temperature changes

Dust

Pollen

Foods

Emotional changes
Complications

Secondary Cutaneous infections

Staphylococcus aureus

Streptococci

Seek Medical Attention if

Pustules

Vesicles

Crusting

Herpes Simples
Atopic Dermatitis Treatment

Goals of Therapy
1.
Maintain skin hydration
2.
Relieve or minimize symptoms of itching and
weeping
3.
Avoid or minimize factors that trigger or aggravate
the disorder
Generalized AD Treatment
Approach

Skin hydration

Trigger avoidance

As with allergy
management

Inflammatory relief

Antipruritic relief

Weeping vesicles relief
AD Treatment – Skin Hydration
Acute/Subacute AD

Bathe every other day

Bathe 3-5 minutes

Pat dry after bathing

Soap choice

Apply moisturizers
within 3 minutes

Control Weeping
Chronic AD

Same as
Acute/Subacute AD

Ointments preferred
for long term control

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6
Inflammatory Relief

Topical Corticosteroids

Hydrocortisone 0.5-1%

MOA

Likely suppresses
cytokines associated
with inflammation and
itching

How to apply

Sparingly to affected