Term
| What makes up the atopic triad? |
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Definition
| Asthma, Allergic rhinitis, AD |
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Term
| What is the most consistent sx of AD? |
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Definition
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Term
| Describe the stepwise progression of the clinical presentation of AD. |
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Definition
| Scratching - excoriation - lichenification - skin breakdown |
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Term
| When does infant AD typ occur? |
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Definition
| 2-6mths of age, 50% resolve by 18 mths |
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Term
| What parts of the infant's skin does AD typ affect? |
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Definition
| Cheeks, chin, forehead, and scalp |
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Term
| Describe the rash in infant AD. |
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Definition
| Itchy, red, often w/ scaling. Pruritus makes infant restless. |
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Term
| What parts of the skin does the childhood stage of AD typ. affect? |
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Definition
| Flexural areas - antecubital and popliteal fossae, wrists and ankles |
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Term
| Describe the rash in the childhood stage of AD. |
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Definition
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Term
| What aggravates the pruritic sx of AD? |
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Definition
| Perspiration, dry air, cold, stress, harsh fabrics (wool) |
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Term
| When does the adult stage of AD begin? |
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Definition
| At puberty when sx worsen or begin, subsides by age 30 |
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Term
| Describe the skin in adult AD. |
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Definition
| Dry, itchy, reddened and cracked - often lichenification |
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Term
| Describe the distribution of skin areas affected by adult AD. |
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Definition
| Can be flexural as in children or more localized (hands, periorbital, or anogenital) |
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Term
| 80% of pts w/ AD have elevated ______. |
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Definition
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Term
| Guidelines for dx of AD requires that a pt has ____ of _____ major criteria or __ of __ minor features. |
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Definition
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Term
| What are the major criteria for dx of AD? |
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Definition
| 1)Pruritus 2)Affects flexural in adults or extensor/face in infants 3)Chronic or relapsing dermatitis 4)Fam h/o atopic triad d/o |
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Term
| A complication of AD is secondary infection w/ what organisms? |
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Definition
| Staph (primary), strep, or herpes |
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Term
| What are the 5 steps for tx AD? |
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Definition
| 1)Education 2)Prevention 3)Mild sx despite routine care 4)Mid-potency steroids and Calcineurin inhibitors 5)Referral |
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Term
| Name 3 ways to prevent flares of AD. |
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Definition
| 1)Moisturize (Moisturel, eucerin, Aquaphor, Vaseline) 2)Avoid perfumed soaps/lotions 3)Decrease bathtime |
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Term
| What meds are used to tx AD w/ mild sx depsite daily care? |
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Definition
| 1)Mild topical steroids (hydrocortisone) 2)Oral antihistamine (claritin, zyrtec, benadryl) |
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Term
| What are advantages to using Calcineurin to tx AD? what is the mechanism of action? Name 2 ex. Who should not use them? |
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Definition
| No skin atrophy or striae. Stop T cells and mast cells from releasing cytokines. Elidel (Pimecrolimus) and protopic (Tacrolimus). Immunocompromised pts. |
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Term
| When would you use 1st generation Cephalosporins to tx AD? |
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Definition
| Honey crust, pustules, cellulitis, unexpected flares and recalcitrant cases |
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Term
| If MRSA is suspected, what abx are used? The nose is a major reservoir of S. aureus, what would you use? |
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Definition
| Bactrim or clindamycin. Mupiricin (bactroban) applied to the nose. |
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Term
| What is the common name for seborrheic dermatitis in children? Adults? |
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Definition
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Term
| What is the pathophysiology of seborrheic dermatitis? |
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Definition
| Poss. Malasezia furfur (skin saprophyte) or Pityrosporum yeast. Hyperproliferation of skin/excess oil secretion. |
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Term
| Describe the clinical findings in seborrheic dermatitis. |
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Definition
| Moist papules w/ yellow, greasy scaling, erythema, mild pruritus |
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Term
| Describe the distribution of affected areas in seborrheic dermatitis. |
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Definition
| Lateral side of nose, nasolabial folds, eyebrows, scalp (dandruff) |
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Term
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Definition
| 1)Frequent washings 2)Antiproliferative shampoos (T-Gel - Tar), Selsun - Se, Head and Shoulders - Zn) 3)Antifungal shampoos (ketoconazole, ciclopirox) |
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Term
| Name 2 other tx for seborrheic dermatitis (other than shampoos). |
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Definition
| Topical steroids and topical or systemic antifungals |
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Term
| What might you think if a pt has severe seborrheic dermatitis? What other dz is seborrheic dermatitis a common finding? |
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Definition
| HIV (up to 80% of AIDS pt have it). Parkinson's dz. |
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Term
| Describe the appearance of nummular dermatitis. |
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Definition
| Generalized, intensely pruritic coin-shaped patches of eczematous dermatitis |
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Term
| Who is nummular eczema more common in? Describe the distribution of skin affected. |
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Definition
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Term
| Name 3 tx for nummular eczema. |
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Definition
| Topical steroid (ointment), moisturization, light tx. Very difficult to tx - variable and unpredictable outbreaks. |
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Term
| Who does dyshidrotic dermatitis typ affect? It is AKA? |
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Definition
| Women - early 20's and Men - mid-40's usu. w/ an atopic hx. Pompholyx. |
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Term
| Describe the clinical presentation of dyshidrotic dermatitis. Describe the areas of distribution. |
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Definition
| Intensely pruritic, recurrent, vesicular lesions 1-5mm diameter w/ clear fluid. Palms and soles, lateral aspects of fingers. |
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Term
| What is the tx for dyshidrotic dermatitis? (4) |
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Definition
| 1)Wet dressings bid 2)Med. to potent topical corticosteroids 3)Oral antihistamines 4)UVA or x-ray in recurrent cases. |
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Term
| Who does perioral dermatitis typ. affect? |
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Definition
| Young women and children 7mths to 13yrs (girls=boys) |
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Term
| The exact etiology of perioral dermatitis is unknown, but what are 3 possible causes? |
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Definition
| 1)Skin intolerance to beauty products 2)Drying agents (benzoyl peroxide, alcohol based products) 3)Bacterial |
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Term
| Describe the clinical presentation of perioral dermatitis and distribution areas. |
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Definition
| Pustules and papules resembling acne around nasolabial folds and chin, sparing the vermilion border |
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Term
| How is perioral dermatitis tx? (3) |
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Definition
| 1)Stop heavy moisturizers, steroids, and cosmetics 3)Use mild soap 4)Topical or oral abx |
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Term
| Stasis dermatitis is an eczematous reaction in pts w/ ______. |
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Definition
| Venous insufficiency in lower legs and ankles (medial malleolus) |
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Term
| Describe subacute stasis dermatitis. |
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Definition
| In winter mths legs become dry and scaly, pruritic (itching worsens it), darkening of skin. |
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Term
| What is used to tx subacute stasis dermatitis? |
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Definition
| Topical corticosteroid ointments (II-V) and Lubricants |
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Term
| Describe acute stasis dermatitis. |
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Definition
| Red, superficial, pruritic plaque, may have cellulitis, weeps and dev. crusts. |
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Term
| Describe chronic stasis dermatitis. |
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Definition
| Cyanotic red plaque over medial malleolus, skin thickening, cycles of healing and recurrent attacks (skin remains thick and dark during healing times) |
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Term
| Name 4 tx for acute/chronic stasis dermatitis. |
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Definition
| 1)Topical steroids (III-V) 2)Oral abx if cellulitis 3)Wet dressings 4)Compression hose |
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Term
| An eruption that is created by habitual scratching of eczematous dermatitis in a single localized area, AKA neurodermatitis. |
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Definition
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Term
| Describe the clinical presentation of lichen complex chronicus. |
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Definition
| Very thick oval plaque, usu. just one lesion, severe itching, lichenification. |
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Term
| Tx for Lichen complex chronicus? |
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Definition
| Stop itching!! Topical steroids or oral if severe. |
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Term
| A chronic inflammatory skin dz char. by pruritus, erythema, a prediliction for skin creases and a relapsing course. |
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Definition
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Term
| 90% of cases of AD present before the age of ___. |
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Definition
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