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Atopic Dermatitis.pptx in pediatrics, presentation
- 1. By Akshaya R S AtopicDermatitis
- 2. A 6-month-old infantis brought with itchy red patches on cheeks, recurrent in the last 2 months. Mother has asthma. Q: What is the probable diagnosis? Case scenario
- 3. Definition Epidemiology and Pathogenesis Clinicalfeatures & Age groups Diagnostic criteria & Differential diagnosis Management & Preventive strategies Atopic dermatitis
- 4. Chronic, relapsing, pruritic,inflammatory skin disorder. Associated with personal/family history of atopy -Asthma -Allergic rhinitis -Eczema Definition Atopy is a genetic condition characterized by increased IgE response to allergens.
- 5. Methodology Atopy Allergy Definition Inherited tendencyto develop IgE-mediated hypersensitivity to common allergens Any abnormal immune response to an allergen (can be IgE-mediated or non- IgE) Genetics Strong genetic predisposition May or may not have genetic link Examples Asthma, atopic dermatitis, allergic rhinitis Drug allergy, food allergy, insect sting allergy, latex allergy All atopic conditions are allergic, but not all allergies are atopic.
- 6. Prevalence: 10–20% ofchildren Onset: 60% before 1 year, 85% before 5 years May improve with age, sometimes persists into adulthood Epidemiology
- 7. Genetics: Filaggrin mutation→ barrier dysfunction Immune dysregulation: ↑ Th2 cytokines → ↑ IgE Environmental triggers: allergens, irritants, infections, climate Pathogenesis
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- 10. Cardinal feature: Rasheswith intense itching Intense itching leading to scratch-itch cycle worsening eczema. Clinical Features
- 11. Methodology Age group Distribution& Morphology Infantile (2 months – 2 yrs) Cheeks, forehead, scalp, extensor surfaces; erythematous, oozing, crusted lesions. Childhood (2 – 12 yrs) Flexural areas (elbows, knees), neck, wrists, ankles; lichenification, dry skin. Adolescent/Adult Flexures, face, hands; chronic lichenified plaques, dry scaly skin.
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- 13. Essential features: •Pruritus •Typical morphology& distribution (age-dependent) •Chronic or relapsing course •Personal/family history of atopy Diagnostic Criteria (Hanifin and Rajka)
- 14. •Seborrheic dermatitis (infantile) •Contactdermatitis •Scabies •Psoriasis Differential Diagnosis
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- 16. •Secondary bacterial infection (Staphylococcusaureus, Streptococcus) •Eczema herpeticum (HSV infection) •Growth retardation (rare, due to poor sleep and nutrition) Complications
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- 18. General measures Avoid triggers:soaps, woolen clothing, dust, allergens. Lukewarm baths; mild soap substitutes. Liberal use of emollients (mainstay of treatment). Management
- 19. Topical corticosteroids: mainstayfor acute flares (lowest potency effective, short duration). Topical calcineurin inhibitors (Tacrolimus, Pimecrolimus): steroid-sparing, esp. face/flexures. Antihistamines: to reduce itching, especially sedating ones at night. Pharmacological therapy
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- 21. Antibiotics: for secondarybacterial infection (oral/ topical). Systemic therapy (rare, severe refractory cases) Phototherapy Cyclosporine, methotrexate, dupilumab Pharmacological therapy
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- 24. Exclusive breastfeeding forfirst 6 months. Avoid early exposure to strong allergens. Skin barrier maintenance with early use of emollients in high-risk infants. Prevention
- 25. Definition – chronic,relapsing, pruritic dermatitis with atopic background. Cardinal feature – intense pruritus. Age-related distribution -infant (face/extensors) -children (flexors) - adolescent/adults (flexors, hands) Summary- Atopic Dermatitis
- 26. Mainstay treatment –emollients + topical steroids. Complications – secondary infection, eczema herpeticum. Summary- Atopic Dermatitis
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