Atopic dermatitis is a chronic, inflammatory skin disease associated with elevated IgE levels and family history of atopy. It is caused by both genetic and environmental factors that impair the skin barrier and lead to immune dysregulation. Key characteristics include intensely pruritic rashes in skin folds and extensor surfaces. Diagnosis is based on pruritus, characteristic rash patterns and locations, chronic relapsing course, and family history of atopy. Impaired skin barrier function, immune abnormalities involving Th2 cells and cytokines, and interactions between nerves, keratinocytes and immune cells all contribute to pathogenesis.
This document provides information on atopic dermatitis (AD), including its definition, epidemiology, pathogenesis, clinical features, complications, diagnosis, and differential diagnosis. AD is defined as an itchy, chronic inflammatory skin condition with a flexural distribution and early age of onset. Genetic and environmental factors contribute to skin barrier dysfunction and immune dysregulation underlying AD. Clinical features vary by age but commonly include dry skin, rashes, and skin thickening/lichenification due to scratching. Secondary infections can occur. Diagnosis is based on characteristic features and history. Differential diagnoses include other eczemas and psoriasis.
1) Dermatitis and eczema refer to inflammation of the skin that can have chronic stages and be caused by endogenous or exogenous factors. Atopic eczema is a chronic pruritic skin condition with a hereditary predisposition that often begins in infancy.
2) Atopic eczema is caused by an immune system imbalance and dysregulation, characterized by elevated IgE levels and cytokine abnormalities. Family history of atopy is present in many cases.
3) Treatment involves identifying triggers, using emollients and topical corticosteroids, managing allergy and infection, and escalating to immunomodulators or systemic therapy if needed. Other conditions discussed include contact dermatitis
Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens over time. While the condition may occur at any age
This document discusses atopic dermatitis (eczema), including its definition, epidemiology, risk factors, pathogenesis, clinical manifestations, and variants. Atopic dermatitis is a chronic inflammatory skin disease characterized by dry, itchy skin and often associated with elevated IgE levels and family history of atopy. Genetic and environmental factors contribute to its development. Clinically it presents differently based on age, from rashes on cheeks/scalp in infants to flexural lichenified plaques in older children/adults. Associated features include palmar hyperlinearity and infra-auricular fissuring.
Atopic dermatitis Position Paper - Latin American Society of Allergy, Asthma ...Juan Carlos Ivancevich
This document provides guidelines for the diagnosis and management of atopic dermatitis (AD) in Latin America. It summarizes the epidemiology, pathophysiology, risk factors, phenotypes, diagnostic criteria and severity scales for AD. Some key points include: AD prevalence is high in Latin America and increasing due to urbanization and lifestyle changes. Multiple genetic and environmental factors are involved in its pathogenesis. Sensitization patterns differ from other regions, with early and high sensitization rates to mites and other allergens common in Latin America. Phenotypes are described based on Th1, Th2 and autoimmune responses. Diagnosis is based on clinical features and severity can be assessed using scales like SCORAD. Laboratory tests for total
This document provides guidelines for the diagnosis and management of atopic dermatitis in Latin America. It was developed by the committee of atopic dermatitis of the Latin American Society of Allergy Asthma and Immunology. The committee reviewed literature and used the Delphi method to define recommendations. Atopic dermatitis is a common skin disease that often precedes other allergic conditions. Its prevalence is high in Latin America due to environmental factors. The pathophysiology involves skin barrier defects and immune/inflammatory responses. Phenotypes are classified based on immunological markers to guide tailored treatment approaches.
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dryness, itchiness, redness, and sometimes oozing. It is one of the most common skin disorders in children, affecting up to 30% of preschoolers. The exact causes are unknown but include genetic susceptibility and environmental triggers weakening the skin barrier. Treatment focuses on moisturizing to repair the barrier, identifying and avoiding triggers, and controlling flares with topical corticosteroids or other immunosuppressants. While there is no cure, many children outgrow eczema by adolescence.
This document provides information on atopic dermatitis (AD), including its definition, epidemiology, pathogenesis, clinical features, complications, diagnosis, and differential diagnosis. AD is defined as an itchy, chronic inflammatory skin condition with a flexural distribution and early age of onset. Genetic and environmental factors contribute to skin barrier dysfunction and immune dysregulation underlying AD. Clinical features vary by age but commonly include dry skin, rashes, and skin thickening/lichenification due to scratching. Secondary infections can occur. Diagnosis is based on characteristic features and history. Differential diagnoses include other eczemas and psoriasis.
1) Dermatitis and eczema refer to inflammation of the skin that can have chronic stages and be caused by endogenous or exogenous factors. Atopic eczema is a chronic pruritic skin condition with a hereditary predisposition that often begins in infancy.
2) Atopic eczema is caused by an immune system imbalance and dysregulation, characterized by elevated IgE levels and cytokine abnormalities. Family history of atopy is present in many cases.
3) Treatment involves identifying triggers, using emollients and topical corticosteroids, managing allergy and infection, and escalating to immunomodulators or systemic therapy if needed. Other conditions discussed include contact dermatitis
Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens over time. While the condition may occur at any age
This document discusses atopic dermatitis (eczema), including its definition, epidemiology, risk factors, pathogenesis, clinical manifestations, and variants. Atopic dermatitis is a chronic inflammatory skin disease characterized by dry, itchy skin and often associated with elevated IgE levels and family history of atopy. Genetic and environmental factors contribute to its development. Clinically it presents differently based on age, from rashes on cheeks/scalp in infants to flexural lichenified plaques in older children/adults. Associated features include palmar hyperlinearity and infra-auricular fissuring.
Atopic dermatitis Position Paper - Latin American Society of Allergy, Asthma ...Juan Carlos Ivancevich
This document provides guidelines for the diagnosis and management of atopic dermatitis (AD) in Latin America. It summarizes the epidemiology, pathophysiology, risk factors, phenotypes, diagnostic criteria and severity scales for AD. Some key points include: AD prevalence is high in Latin America and increasing due to urbanization and lifestyle changes. Multiple genetic and environmental factors are involved in its pathogenesis. Sensitization patterns differ from other regions, with early and high sensitization rates to mites and other allergens common in Latin America. Phenotypes are described based on Th1, Th2 and autoimmune responses. Diagnosis is based on clinical features and severity can be assessed using scales like SCORAD. Laboratory tests for total
This document provides guidelines for the diagnosis and management of atopic dermatitis in Latin America. It was developed by the committee of atopic dermatitis of the Latin American Society of Allergy Asthma and Immunology. The committee reviewed literature and used the Delphi method to define recommendations. Atopic dermatitis is a common skin disease that often precedes other allergic conditions. Its prevalence is high in Latin America due to environmental factors. The pathophysiology involves skin barrier defects and immune/inflammatory responses. Phenotypes are classified based on immunological markers to guide tailored treatment approaches.
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dryness, itchiness, redness, and sometimes oozing. It is one of the most common skin disorders in children, affecting up to 30% of preschoolers. The exact causes are unknown but include genetic susceptibility and environmental triggers weakening the skin barrier. Treatment focuses on moisturizing to repair the barrier, identifying and avoiding triggers, and controlling flares with topical corticosteroids or other immunosuppressants. While there is no cure, many children outgrow eczema by adolescence.
This document discusses eczema, including its classification, symptoms, and treatment. It begins by defining eczema as a skin condition characterized by itching and scratching. It then classifies eczema based on etiology, morphology, and chronicity. Symptoms of acute eczema include erythema, vesicles, and crusting, while chronic eczema features lichenification. Complications can be dermatological like infection or psychosocial like anxiety. Treatment involves identifying triggers, moisturizing, and using topical corticosteroids or immunosuppressants. It also focuses on atopic dermatitis, its causes, features in infants/children/adults, and management through avoidance of
A 12-year-old female presents with dry, itchy skin on her elbows, behind her knees, and in front of her ankles. She has a family history of atopic dermatitis, asthma, and eczema. Atopic dermatitis is a chronic inflammatory skin disease characterized by dry skin and intense itching. It most commonly presents in infants and young children, with flexural areas of the skin most severely affected. Management involves hydration, topical corticosteroids and antihistamines to reduce inflammation and itching.
The document discusses atopic dermatitis (AD), also known as eczema. It defines AD as a pruritic, chronic inflammatory skin condition characterized by dry skin and itchy rashes. AD is common in childhood and often runs in families with other allergic diseases. The pathogenesis involves genetic predisposition, skin barrier defects, and abnormal immune responses. Clinical manifestations vary depending on the stage of life, from facial rashes in infants to thickened plaques on flexural areas in older patients. Treatment focuses on moisturizing the skin, identifying trigger factors, and using topical corticosteroids or calcineurin inhibitors to control symptoms.
Atopic dermatitis. Presentation in pediatric caseAnjaliSahare
Atopic dermatitis is a chronic, relapsing form of eczema characterized by dry skin and itchy, recurrent lesions. While its exact etiology is unclear, there is a genetic predisposition involving the immune system. Clinically, it presents in two patterns - an infantile onset involving the face and risk of generalization, and a childhood pattern of dry, lichenified plaques on the extremities. Treatment focuses on patient education to avoid scratching, limiting irritant exposure, using mild cleansers, and reducing house dust mites. Dietary restrictions and vaccinations are generally not contraindicated except in specific egg allergies.
Children's skin problems span nearly two decades from birth through adolescence. Several common pediatric skin conditions will be discussed including: diaper dermatitis, atopic dermatitis, warts, and acne.
follow me on my YouTube channel :- medic o mania
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that is common in children under 5 years old. It causes red, itchy patches that flare up due to triggers like skin irritants, allergens, stress, and skin infections. While eczema is usually not serious, it can significantly impact quality of life. Diagnosis involves visible rashes in skin folds or other areas plus a personal or family history of eczema, asthma, dry skin or other atopic conditions. Potential trigger factors and signs of bacterial infection should be assessed and treated appropriately.
L3-Dermatitis - eczema and related disorder OmarHamwi4
This document discusses different types of dermatitis (eczema) including their definitions, classifications, clinical presentations, pathogeneses and management approaches. It covers common types such as atopic dermatitis, seborrheic dermatitis, contact dermatitis, nummular dermatitis and neurodermatitis. For each type, it describes their characteristic features, underlying causes and recommended treatment lines. The document aims to help recognize different eczema subtypes and understand their management.
Atopic dermatitis is a chronic inflammatory skin condition that often starts in early childhood. It is caused by complex interactions between genetic, immune, and environmental risk factors. A defective skin barrier is a consistent feature of atopic dermatitis. Filaggrin gene mutations contribute to impaired skin barrier function. Diagnosis is based on clinical features like itchy skin rashes and personal or family history of atopy. Treatment focuses on managing symptoms and avoiding triggers while working to strengthen the skin barrier.
Dr Muhammad Raza's presentation provides information about atopic dermatitis (eczema), including its signs and symptoms, causes, diagnosis, and management. The key points are that it is a chronic skin condition causing red, itchy, cracked skin that is common in children; has genetic and immunological factors; and is typically diagnosed clinically and managed through moisturizers, topical steroids, and other topical or systemic treatments depending on severity. The goal is for participants to understand the basic concepts, diagnosis, management, and appropriate referrals for atopic dermatitis.
Exfoliative dermatitis is a condition where more than 90% of the skin surface becomes inflamed and scaly. It can be caused by underlying skin diseases like psoriasis or eczema, drug reactions, or systemic illnesses. Clinically, it presents as generalized redness and scaling of the skin with potential complications involving other organs. Making an accurate diagnosis requires considering the patient's medical history and risk factors, examining skin changes and biopsy findings, and ruling out potential etiologies through laboratory tests and imaging.
This chapter discusses the clinical symptoms of atopic eczema. It describes itch as the primary symptom, with scratching leading to rashes. Flexural dermatitis is often visible. Atopic eczema typically starts in infancy and affects the face, neck, and limbs, following a craniocaudal pattern. The course is often constant eczema in infancy, followed by periods of remission and relapse in childhood, with 15-25% continuing into adulthood. Secondary infections are common. Various clinical features like papules, lichenification, and hyperpigmentation are discussed.
This chapter discusses the clinical symptoms of atopic eczema. It describes itch as the primary symptom, with scratching leading to rashes. Flexural dermatitis is often visible. Atopic eczema typically starts in infancy and affects the face, neck, and limbs, following a craniocaudal pattern. The course is often constant eczema in infancy, followed by periods of remission and relapse in childhood, with 15-25% continuing into adulthood. Secondary infections are common. Various clinical features like papules, lichenification, and hyperpigmentation are discussed.
This document discusses various types of dermatitis and eczema. It begins with an introduction noting that dermatitis and eczema refer to inflammation of the skin. Eczema progresses through acute, subacute, and chronic stages. Prevalence in the US is 10-12% in children and 0.9% in adults, rising internationally. Atopic eczema is a chronic pruritic inflammation affecting the epidermis and dermis, commonly presenting in infants and children. Contact dermatitis results from allergic or irritant reactions to substances touching the skin. Other conditions discussed include lichen simplex chronicus, discoid eczema, seborrhoeic dermatitis, and
1. Acne is a common skin disorder of hair follicles and sebaceous glands caused by excess sebum production, abnormal keratinization, and P. acnes bacteria. It presents with inflamed lesions like papules, pustules, and nodules on the face, neck, back and chest.
2. Pemphigus vulgaris is a chronic autoimmune blistering disease caused by IgG antibodies. It presents with flaccid blisters that rupture easily, causing raw areas and possible infection.
3. Psoriasis is a chronic inflammatory skin condition characterized by red, scaly plaques, often located on the scalp, elbows, knees, and
Atopic dermatitis is a chronic, pruritic inflammatory skin condition seen in individuals with a personal or family history of atopy. It is characterized by periods of flare-ups and remission influenced by environmental and emotional factors. The diagnosis is based on clinical features including pruritus, typical morphology and distribution of lesions, and a history of atopy. Management involves identifying triggering factors, using topical emollients and corticosteroids, oral antihistamines and antibiotics, and more intensive therapies for severe cases such as phototherapy or immunosuppressants.
This document discusses atopic dermatitis (AD), also known as eczema. It defines AD as an itchy, chronic skin condition often starting in childhood characterized by rashes, redness, itchy bumps and blisters that may become cracked or thickened. The document discusses the etiology and pathogenesis of AD involving skin barrier dysfunction and immune system abnormalities. It describes the clinical features of AD in infants, children and adults and provides diagnostic criteria. Treatment recommendations include moisturizers, bathing, wet wrap therapy, topical corticosteroids and avoiding topical antihistamines.
This document discusses atopic dermatitis (AD), also known as eczema. It describes the characteristic features of AD including pruritis, eczematous lesions, and association with other atopic conditions. It outlines the three stages of AD - infantile, childhood, and adult. It discusses immunological factors, common triggers, differential diagnoses, management strategies, and regional variants. AD results from a T helper 2 cell dominant immune response and is characterized by IgE elevation and eosinophilia. Proper management focuses on protection from scratching, cleansing, moisturizing, and topical corticosteroids.
1. Atopic dermatitis is a chronic, inflammatory skin condition characterized by red, itchy rashes. It often begins in childhood and involves skin folds and surfaces like the cheeks, elbows, and knees.
2. The causes involve both genetic and environmental factors like skin barrier dysfunction and immune system abnormalities that make the skin prone to inflammation. Factors like temperature changes, sweating, allergens, and stress can trigger flare ups.
3. Treatment involves moisturizers, bathing, topical corticosteroids for flare ups, and limiting irritant exposure and scratching. Antibiotics may be used if secondary bacterial infection develops but topical antihistamines are not recommended.
Pyoderma and bacterial skin infections can take several forms including impetigo, cellulitis, folliculitis, boils, and carbuncles. Impetigo is a superficial infection caused by Streptococcus or Staphylococcus that presents as crusty lesions that are contagious. Cellulitis is a deep bacterial skin infection commonly caused by Streptococcus or Staphylococcus that presents as swollen, warm, painful skin with red streaks and fever. Staphylococcal scalded skin syndrome causes skin reddening and blistering that gives the skin a burned appearance and is usually not life-threatening in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
This document discusses eczema, including its classification, symptoms, and treatment. It begins by defining eczema as a skin condition characterized by itching and scratching. It then classifies eczema based on etiology, morphology, and chronicity. Symptoms of acute eczema include erythema, vesicles, and crusting, while chronic eczema features lichenification. Complications can be dermatological like infection or psychosocial like anxiety. Treatment involves identifying triggers, moisturizing, and using topical corticosteroids or immunosuppressants. It also focuses on atopic dermatitis, its causes, features in infants/children/adults, and management through avoidance of
A 12-year-old female presents with dry, itchy skin on her elbows, behind her knees, and in front of her ankles. She has a family history of atopic dermatitis, asthma, and eczema. Atopic dermatitis is a chronic inflammatory skin disease characterized by dry skin and intense itching. It most commonly presents in infants and young children, with flexural areas of the skin most severely affected. Management involves hydration, topical corticosteroids and antihistamines to reduce inflammation and itching.
The document discusses atopic dermatitis (AD), also known as eczema. It defines AD as a pruritic, chronic inflammatory skin condition characterized by dry skin and itchy rashes. AD is common in childhood and often runs in families with other allergic diseases. The pathogenesis involves genetic predisposition, skin barrier defects, and abnormal immune responses. Clinical manifestations vary depending on the stage of life, from facial rashes in infants to thickened plaques on flexural areas in older patients. Treatment focuses on moisturizing the skin, identifying trigger factors, and using topical corticosteroids or calcineurin inhibitors to control symptoms.
Atopic dermatitis. Presentation in pediatric caseAnjaliSahare
Atopic dermatitis is a chronic, relapsing form of eczema characterized by dry skin and itchy, recurrent lesions. While its exact etiology is unclear, there is a genetic predisposition involving the immune system. Clinically, it presents in two patterns - an infantile onset involving the face and risk of generalization, and a childhood pattern of dry, lichenified plaques on the extremities. Treatment focuses on patient education to avoid scratching, limiting irritant exposure, using mild cleansers, and reducing house dust mites. Dietary restrictions and vaccinations are generally not contraindicated except in specific egg allergies.
Children's skin problems span nearly two decades from birth through adolescence. Several common pediatric skin conditions will be discussed including: diaper dermatitis, atopic dermatitis, warts, and acne.
follow me on my YouTube channel :- medic o mania
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that is common in children under 5 years old. It causes red, itchy patches that flare up due to triggers like skin irritants, allergens, stress, and skin infections. While eczema is usually not serious, it can significantly impact quality of life. Diagnosis involves visible rashes in skin folds or other areas plus a personal or family history of eczema, asthma, dry skin or other atopic conditions. Potential trigger factors and signs of bacterial infection should be assessed and treated appropriately.
L3-Dermatitis - eczema and related disorder OmarHamwi4
This document discusses different types of dermatitis (eczema) including their definitions, classifications, clinical presentations, pathogeneses and management approaches. It covers common types such as atopic dermatitis, seborrheic dermatitis, contact dermatitis, nummular dermatitis and neurodermatitis. For each type, it describes their characteristic features, underlying causes and recommended treatment lines. The document aims to help recognize different eczema subtypes and understand their management.
Atopic dermatitis is a chronic inflammatory skin condition that often starts in early childhood. It is caused by complex interactions between genetic, immune, and environmental risk factors. A defective skin barrier is a consistent feature of atopic dermatitis. Filaggrin gene mutations contribute to impaired skin barrier function. Diagnosis is based on clinical features like itchy skin rashes and personal or family history of atopy. Treatment focuses on managing symptoms and avoiding triggers while working to strengthen the skin barrier.
Dr Muhammad Raza's presentation provides information about atopic dermatitis (eczema), including its signs and symptoms, causes, diagnosis, and management. The key points are that it is a chronic skin condition causing red, itchy, cracked skin that is common in children; has genetic and immunological factors; and is typically diagnosed clinically and managed through moisturizers, topical steroids, and other topical or systemic treatments depending on severity. The goal is for participants to understand the basic concepts, diagnosis, management, and appropriate referrals for atopic dermatitis.
Exfoliative dermatitis is a condition where more than 90% of the skin surface becomes inflamed and scaly. It can be caused by underlying skin diseases like psoriasis or eczema, drug reactions, or systemic illnesses. Clinically, it presents as generalized redness and scaling of the skin with potential complications involving other organs. Making an accurate diagnosis requires considering the patient's medical history and risk factors, examining skin changes and biopsy findings, and ruling out potential etiologies through laboratory tests and imaging.
This chapter discusses the clinical symptoms of atopic eczema. It describes itch as the primary symptom, with scratching leading to rashes. Flexural dermatitis is often visible. Atopic eczema typically starts in infancy and affects the face, neck, and limbs, following a craniocaudal pattern. The course is often constant eczema in infancy, followed by periods of remission and relapse in childhood, with 15-25% continuing into adulthood. Secondary infections are common. Various clinical features like papules, lichenification, and hyperpigmentation are discussed.
This chapter discusses the clinical symptoms of atopic eczema. It describes itch as the primary symptom, with scratching leading to rashes. Flexural dermatitis is often visible. Atopic eczema typically starts in infancy and affects the face, neck, and limbs, following a craniocaudal pattern. The course is often constant eczema in infancy, followed by periods of remission and relapse in childhood, with 15-25% continuing into adulthood. Secondary infections are common. Various clinical features like papules, lichenification, and hyperpigmentation are discussed.
This document discusses various types of dermatitis and eczema. It begins with an introduction noting that dermatitis and eczema refer to inflammation of the skin. Eczema progresses through acute, subacute, and chronic stages. Prevalence in the US is 10-12% in children and 0.9% in adults, rising internationally. Atopic eczema is a chronic pruritic inflammation affecting the epidermis and dermis, commonly presenting in infants and children. Contact dermatitis results from allergic or irritant reactions to substances touching the skin. Other conditions discussed include lichen simplex chronicus, discoid eczema, seborrhoeic dermatitis, and
1. Acne is a common skin disorder of hair follicles and sebaceous glands caused by excess sebum production, abnormal keratinization, and P. acnes bacteria. It presents with inflamed lesions like papules, pustules, and nodules on the face, neck, back and chest.
2. Pemphigus vulgaris is a chronic autoimmune blistering disease caused by IgG antibodies. It presents with flaccid blisters that rupture easily, causing raw areas and possible infection.
3. Psoriasis is a chronic inflammatory skin condition characterized by red, scaly plaques, often located on the scalp, elbows, knees, and
Atopic dermatitis is a chronic, pruritic inflammatory skin condition seen in individuals with a personal or family history of atopy. It is characterized by periods of flare-ups and remission influenced by environmental and emotional factors. The diagnosis is based on clinical features including pruritus, typical morphology and distribution of lesions, and a history of atopy. Management involves identifying triggering factors, using topical emollients and corticosteroids, oral antihistamines and antibiotics, and more intensive therapies for severe cases such as phototherapy or immunosuppressants.
This document discusses atopic dermatitis (AD), also known as eczema. It defines AD as an itchy, chronic skin condition often starting in childhood characterized by rashes, redness, itchy bumps and blisters that may become cracked or thickened. The document discusses the etiology and pathogenesis of AD involving skin barrier dysfunction and immune system abnormalities. It describes the clinical features of AD in infants, children and adults and provides diagnostic criteria. Treatment recommendations include moisturizers, bathing, wet wrap therapy, topical corticosteroids and avoiding topical antihistamines.
This document discusses atopic dermatitis (AD), also known as eczema. It describes the characteristic features of AD including pruritis, eczematous lesions, and association with other atopic conditions. It outlines the three stages of AD - infantile, childhood, and adult. It discusses immunological factors, common triggers, differential diagnoses, management strategies, and regional variants. AD results from a T helper 2 cell dominant immune response and is characterized by IgE elevation and eosinophilia. Proper management focuses on protection from scratching, cleansing, moisturizing, and topical corticosteroids.
1. Atopic dermatitis is a chronic, inflammatory skin condition characterized by red, itchy rashes. It often begins in childhood and involves skin folds and surfaces like the cheeks, elbows, and knees.
2. The causes involve both genetic and environmental factors like skin barrier dysfunction and immune system abnormalities that make the skin prone to inflammation. Factors like temperature changes, sweating, allergens, and stress can trigger flare ups.
3. Treatment involves moisturizers, bathing, topical corticosteroids for flare ups, and limiting irritant exposure and scratching. Antibiotics may be used if secondary bacterial infection develops but topical antihistamines are not recommended.
Pyoderma and bacterial skin infections can take several forms including impetigo, cellulitis, folliculitis, boils, and carbuncles. Impetigo is a superficial infection caused by Streptococcus or Staphylococcus that presents as crusty lesions that are contagious. Cellulitis is a deep bacterial skin infection commonly caused by Streptococcus or Staphylococcus that presents as swollen, warm, painful skin with red streaks and fever. Staphylococcal scalded skin syndrome causes skin reddening and blistering that gives the skin a burned appearance and is usually not life-threatening in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
2. INTRODUCTION
• Atopic dermatitis is a chronic, relapsing, pruritic, inflammatory skin disease
• often associated with an elevated serum level of immunoglobulin E (IgE)
• often associated with a personal or family history of atopy
• sensitization to environmental or food allergens is clearly associated with the
atopic dermatitis phenotype, it does not seem to be a causative factor
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
3. Epidemiology
• increased two- to threefold over the past 30 years
• 5–20% of children and 2–10% of adults are affected
• the first manifestation of the atopic march
--- Approximately 50% of affected children show symptoms in the first
year of life
Nelson Essentials of Pediatrics
Ninth Edition
4. Current Insights into Atopic March
Children 2021, 8(11), 1067; https://doi.org/10.3390/children811106
P.1
5. Epidemiology
higher rates of atopic dermatitis :
• Africa, Oceania and Asia-Pacific --- overall prevalence of Taiwan is 4.6-
6.7%(2020台灣皮膚科醫學會異位性皮膚炎診療共識)
• slight female preponderance
• urban areas and high-income countries
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
6. Risk factors
Genetic risk factors
• Loss-of-function variants in the
FLG gene
• genes involved in the regulation
of innate host defenses and T
cell function
Environmental exposures
• Climate(溫度、濕度)
• air pollution
• inverse relationship with early
exposure to nonpathogen
microorganisms ---hygiene
hypothesis
• water hardness(high hardness)
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
7. Allergy, Parasites, and the Hygiene Hypothesis
MARIA YAZDANBAKHSH, PETER G. KREMSNER, AND RONALD VAN REEAuthors Info & Affiliations
SCIENCE 19 Apr 2002 Vol 296, Issue 5567 pp. 490-494 DOI: 10.1126/science.296.5567.490
8. Etiology
內因
• impaired skin barrier function
• immunologic abnormalities
• Neuroimmune interactions
外因
• environmental interactions
• Alteration of cutaneous
microbiome
• infectious triggers
Nelson Essentials of Pediatrics
Ninth Edition
9. What Causes Eczema?
Reviewed by Mark Boguniewicz, MD (July 01, 2015)
https://www.nationaljewish.org/conditions/eczema-
atopic-dermatitis/what-causes-eczema
10. PATHOPHYSIOLOGY
impaired skin barrier function is caused by :
1.reduced filaggrin production
2.imbalance between stratum corneum protease and antiprotease
activity
3.tight junction abnormalities
4.altered composition and lamellar organization of epidermal lipids,
microbial colonization
5.itch-scratch cycle
6.release of proinflammatory cytokines
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
12. PATHOPHYSIOLOGY
FLG variants
• filaggrin precursor profilaggrin is encoded by the FLG gene, located in the
epidermal differentiation complex on chromosome 1q23.3
• associated with specific atopic dermatitis phenotypes---early-onset and
persistent disease…
• FLG genotype may also influence the response to treatment
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis AUTHOR:William Howe, MD
UpToDate
13. PATHOPHYSIOLOGY
1.Stimulation of TLRs
2. Release of alarmins activate inflammatory type 2 immune cells
3. Activated Th2 cells release IL-4 and IL-13
4. Affecting the epidermal barrier function by suppressing the expression of
terminal keratinocyte differentiation genes(eg, FLG)
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
14. PATHOPHYSIOLOGY
immunologic abnormalities
• Both the innate and acquired immune responses have a role in the
pathogenesis of type 2 inflammation in atopic dermatitis
• cytokine cluster on chromosome 5q31.1 including genes encoding IL-13 and
IL-4
• the locus on chromosome 11q13.5 involved in the regulation of innate host
defenses and T cell function
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
15. PATHOPHYSIOLOGY
Neuroimmune interactions
• Itch is mediated by
1.unmyelinated, histamine-sensitive
2.non-histamine-sensitive peripheral C-nerve fibers
• Chronic itch results from complex interactions among non-histamine-
sensitive peripheral C-nerve fibers, keratinocytes, and Th2 immune cells.
• Type 2 cytokines, including IL-4, IL-13, and IL-31, are thought to be relevant
mediators of chronic itch in atopic dermatitis
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
16. Clinical Manifestations
Common features Acute 1.intensely pruritic
2.erythematous papules
3.vesicles with exudation
subacute or chronic 1.Dry, scaly, or excoriated,
erythematous papules
2.lichenification
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
17. Clinical
Manifestations
• In children and adults with deeply
pigmented skin, erythema may appear
dark brown
infants 1.pruritic, red, scaly, and crusted
lesions
2.face, scalp, cheeks, and
extensor surfaces of the
extremities
(diaper area沒有)
children 1. less exudation and often
demonstrates lichenified plaques
2.antecubital and popliteal fossae,
head, and neck
3. atopic dirty neck
adolescents and
adults
1.localized and lichenified plaques
2.flexural areas , head and neck
regions
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
18. Clinical Manifestations
Associated features---a variety of cutaneous findings
• Centrofacial pallor
• White dermographism(皮膚畫紋症)
• Keratosis pilaris (毛孔角化症)
• Palmar hyperlinearity
• Pityriasis alba (白色糠疹)
• Periorbital darkening ("allergic shiners") and Dennie-Morgan infraorbital folds
• Thinning or absence of the lateral portion of the eyebrows (Hertoghe's sign)
• Infra-auricular and retroauricular fissuring
• Nipple eczema
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
26. Clinical
variants
Regional and morphologic variants of atopic
dermatitis have been described in both
children and adults
• Atopic hand eczema
1.involving the volar wrists and dorsum of
the hands
2.most common in adults
3. exposed to "wet work" environments
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
28. Clinical variants
• Clinical variants
1.may be the only manifestation
2.associated with lichenification
3.presence of Dennie-Morgan lines
• Atopic cheilitis
1. characterized by dryness, peeling, and fissuring of the lips
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
30. Laboratory findings
• 80 percent of patients have increased serum IgE levels, often with
eosinophilia
• IgE level tends to vary with disease severity
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
31. Diagnosis
ESSENTIAL FEATURES
• Pruritus
• Facial and extensor eczema in
infants and children
• Flexural eczema in adults
• Chronic or relapsing dermatitis
FREQUENTLY ASSOCIATED FEATURES
• Personal or family history of atopic
disease
• Xerosis
• Cutaneous infections
• Nonspecific dermatitis of the hands
or feet
• Elevated serum IgE levels
• Positive immediate-type allergy
skin tests
• Early age of onset
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Ninth Edition
32. Diagnostic criteria
The United Kingdom Working Group on atopic dermatitis criteria
• itchy skin, plus three or more of the following :
History of skin creases being involved including antecubital fossae, popliteal fossae, neck, areas around eyes,
and fronts of ankles.
• History of asthma or hay fever (or history of atopic disease in a first-degree relative for children <4 years of
age).
• The presence of generally dry skin within the past year.
• Symptoms beginning in a child before the age of two years. This criterion is not used to make the diagnosis in a
child who is under four years old.
• Visible dermatitis involving flexural surfaces. For children under four years of age, this criterion is met by
dermatitis affecting the cheeks or forehead and outer aspects of the extremities
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
33. Diagnostic criteria
The American Academy of Dermatology
criteria for the diagnosis of atopic
dermatitis
Essential features 1.Pruritus
2.Eczema (acute,
subacute, chronic) with
typical morphology and
age-specific patterns
3.Chronic or relapsing
history
Important features 1.Early age of onset
2.Personal and/or family
history of atopy
3.IgE reactivity
4.Xerosis
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
38. Differential Diagnosis
2. Langerhans cell histiocytosis
• hemorrhagic or petechial lesions(小出血點<3mm)
Nelson Essentials of Pediatrics
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39. Differential Diagnosis
3.Seborrheic dermatitis
• most common differential diagnosis in infants.
• presence of salmon-red, erythematous skin patches with greasy scale,
involvement of the scalp
• little or no pruritus
• may coexist with atopic dermatitis
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
40. Differential Diagnosis
4.Allergic or irritant contact dermatitis
• history of exposure to irritants or potential sensitizers
• a relevant patch test positivity suggest the diagnosis of contact dermatitis.
• skin biopsy is not useful to distinguish irritant or allergic contact dermatitis
from atopic dermatitis(identical histopathologic features)
• may coexist with atopic dermatitis
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
41. Differential Diagnosis
5. Psoriasis
• often involves the diaper area, with well-demarcated, erythematous patches
with little scale in infants and young children
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
42. Differential Diagnosis
6.Scabies
• intensely pruritic skin
• presence of burrows(疥隧道) in interdigital spaces and flexor surfaces of the
wrists, elbows, axilla, or genitals
• presence of vesicopustules on the palms and soles suggest the diagnosis of
scabies
• The demonstration of mites or eggs by skin scraping or dermoscopy can
confirm the diagnosis
Nelson Essentials of Pediatrics
Ninth Edition
43. Differential Diagnosis
Less common conditions may be confused
• Exanthematous (maculopapular) drug eruption
• Zinc deficiency
• Netherton syndrome
• Cutaneous T cell lymphoma
Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis
AUTHOR:William Howe, MD
UpToDate
44. Treatment
• skin hydration with emollients
• lukewarm baths for 15–20 minutes+application of fragrance-free emollients
• avoidance of triggers
• pharmacologic therapy to reduce pruritus and inflammation
Nelson Essentials of Pediatrics
Ninth Edition
45. Topical antiinflammatory agents
Topical corticosteroids
• effective for the acute and
chronic phases
• The least potent
corticosteroid should be used
• Low-potency
nonfluorinated(非氟化)
corticosteroids should be used
on the face, intertriginous
areas, and large areas
• Local adverse effects---skin
atrophy and striae
Immunomodulators(tacrolimus,
pimecrolimus and Crisaborole )
• second-line agents
• short-term and intermittent
treatment
• used on all body locations and
are especially useful on delicate
skin
• The most common adverse is
local skin irritation
Nelson Essentials of Pediatrics
Ninth Edition
46. Severe, refractory atopic dermatitis
• systemic corticosteroids
• Cyclosporine
• dupilumab(IL-4、IL-13 inhibitor)
• rarely, antimetabolites such as mycophenolate mofetil or methotrexate
• Phototherapy
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Ninth Edition
47. Complications
• 90% of patients with atopic dermatitis have colonization of lesional skin with
Staphylococcus aureus (S. aureus)
• associated with disease severity. S. aureus secretes exotoxins that act as
superantigens
• infected atopic dermatitis often presents as impetiginous(膿痂疹), pustular
lesions with crusting and honey-colored exudate
Nelson Essentials of Pediatrics
Ninth Edition
48. Complications
Herpes simplex superinfection(Kaposi varicelliform eruption)(eczema
herpeticum)
• A rare complication, occurring in less than 3 % of patients
• occasionally being recurrent
• misdiagnosed as bacterial infection and should be considered if skin lesions
fail to respond to antibiotics.
• Coxsackieviruses may produce similar lesions
Nelson Essentials of Pediatrics
Ninth Edition
50. Prognosis
• Symptoms become less severe in two thirds of children, with complete remission for
approximately 20%
• More widespread early onset disease that is concomitant with asthma and allergic rhinitis,
family history of atopic dermatitis, and elevated serum IgE levels may predict a more
persistent course
• a single cause and cure for atopic dermatitis is unlikely
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51. Prevention
• identify and avoid allergens and irritants including soaps, detergents, fragrances, chemicals,
smoke, and extremes of temperature and humidity
• wool and synthetic fabrics can be irritating to the skin, 100% cotton fabric is preferred.
• Sweating is a recognized trigger.
• Fingernails should be trimmed
Nelson Essentials of Pediatrics
Ninth Edition
Approximately 50% of affected children show symptoms in the first year of life, and 80% experience disease onset before 5 years of age
In the United States, the overall prevalence is approximately 16 percent 美國黑人19%
family history of atopy:70 percent of patients have a positive family history of atopic diseases. Children with one atopic parent have a two- to threefold increased risk of developing atopic dermatitis
FLG gene : including allergic contact dermatitis, asthma, and food allergy
Two systematic reviews provided evidence to support an inverse relationship between atopic dermatitis and exposure to endotoxin, early daycare, helminth(蠕蟲) infestation, number of siblings, farm animals, and pet dogs in early life(病毒、細菌沒用)
2021 meta-analysis of seven observational studies that included nearly 386,000 participants found a modest increase of risk of atopic dermatitis in children exposed to hard water (odds ratio [OR] 1.28, 95% CI 1.09-1.50). However, the authors considered the certainty of this estimate to be very low, due to high risk of bias and heterogeneity in the definition of “hard water.”對硬水定義不明確
A meta-analysis of 95 observational studies found that 70 percent of patients with atopic dermatitis carried S. aureus on lesional skinstriking decrease in the skin microbial diversity during flares, with reduction of Streptococcus, Corynebacterium, and Propionibacterium genera and increase in S. aureus density
exaggerated cutaneous inflammatory response to environmental triggers
內因:A diverse set of genes encoding epidermal structural proteins (filaggrin) and elements of the immune system play a major role in atopic dermatitis
Activated Langerhans cells in the dermis expressing surface-bound immunoglobulin E (IgE) stimulate T cells
activated Th2 lymphocytes infiltrate the dermis
through interleukin 4 (IL-4), IL-13, and IL-5
stratum corneum(角質層), which consists of vertical stacks of anucleate corneocytes packed with keratin filaments embedded in a matrix of filaggrin breakdown products
results in increased transepidermal water loss, increased permeability, reduced water retention, and altered lipid composition
Tight junctions are located in the granular layer of the epidermis below the stratum corneum and are thought to seal the intercellular space to prevent the free diffusion of macromolecules
Inflammatory cytokines, such as interleukin (IL) 4, IL-13, IL-17A, IL- 22, IL-25, and IL-31, have also been shown to suppress filaggrin expression
stratum corneum(角質層), which consists of vertical stacks of anucleate corneocytes packed with keratin filaments embedded in a matrix of filaggrin breakdown products
results in increased transepidermal water loss, increased permeability, reduced water retention, and altered lipid composition
2.FLG不同variants影響表現型 包括early-onset and persistent disease; increased risk of asthma, allergic rhinitis, and food allergy; increased prevalence and persistence of hand and foot dermatitis during adulthood; and multiple contact allergies
3.3321delA in East Asian patients K4022X in Korean and Northern Chinese patients S2554X, S2889X, S3296X, and Q1701X in Japanese patients
1.Stimulation of TLRs by tissue damage or microorganisms leads to the release of a wide range of danger signals (alarmins) such as IL-1A
2. The release of alarmins triggered by epithelial barrier disruption activates inflammatory dendritic epidermal cells and type 2 immune cells, including Th2 cells
3. Activated Th2 cells release IL-4 and IL-13, which promote inflammation as well as B cell IgE class switching
4. Th2 cytokines (IL-4, IL-13, IL-31, and IL-22) affect the epidermal barrier function by suppressing the expression of terminal keratinocyte differentiation genes (eg, FLG, loricrin, involucrin)
responsiveness of itch to inhibition of the IL-4 receptor (dupilumab) and downstream IL-4 signaling (Janus kinase [JAK] inhibitors) supports the relevance of these neuroimmune interactions in the pathogenesis of chronic atopic itch
1.The sides of the neck may show a reticulate pigmentation
2. In all age groups, any area of the body can be involved in severe cases, although it is uncommon to see lesions in the axillary, gluteal, or groin area. Lesions in these locations should prompt consideration of other diagnoses, such as psoriasis, allergic contact dermatitis, or seborrheic dermatitis
1.Although considered minor diagnostic criteria, these findings are frequently seen and may be supportive of the diagnosis of atopic dermatitis in some patients
2.Regional and morphologic variants of atopic dermatitis have been described in both children and adults
may be the only manifestation of atopic dermatitis or occur in association with the classic age-related manifestations
Because of the high variability of clinical presentation, related to age, ethnicity, and severity, the diagnosis may be difficult, especially in infants and older adults.
皮膚切片:Skin biopsy is of little value, but may be performed to exclude other skin diseases
過敏原檢查:Skin testing or serum specific IgE testing may be helpful in assessing the contribution of food or environmental allergies to disease expression if history is suggestive
1.goals of eczema therapy are to reduce the number and severity of flares and to increase duration of disease-free periods
2.Prevention of xerosis(乾燥症) is important for pruritus control
3.Emollients should be ointments or creams. Lotions are not as effective because they contain water or alcohol and may have a drying effect owing to evaporation.
4.A mild nonsoap cleanser also is recommended
Corticosteroids are ranked by potency into seven classes
Higher potency corticosteroids should be used for limited periods
systemic adverse effects (hypothalamic-pituitary-adrenal axis suppression and hyperglycemia) ---緩解要降級
superantigens, stimulating T cells and increasing IgE production
Topical antibiotics, such as mupirocin or retapamulin, can be used to treat local areas of infection. Oral antibiotics such as cephalexin, dicloxacillin, or amoxicillin-clavulanate can be used for multifocal disease or for infection around the eyes and mouth that is difficult to treat topically
Bacterial cultures may be helpful in patients who do not respond to oral antibiotics or who have infection after multiple antibiotic courses given the increasing incidence of community-acquired methicillin-resistant S. aureus(MRSA)
A pooled analysis of 45 studies including over 110,000 subjects found that 20 percent of cases of childhood atopic dermatitis had persistent disease eight years after the diagnosis and less than 5 percent had persistent disease 20 years after the diagnosis
The age of onset was the main factor associated with persistence of atopic dermatitis. The hazard ratio was 2.65 (95% CI 2.54-2.75) for onset at age 2 to 5 years, 4.22 (95% CI 3.86-4.61) for onset at age 6 to 11 years, and 2.04 (95% CI 1.66-2.49) for onset at age 12 to 17 years compared with age of onset <2 years
Other risk factors for persistence were disease severity and duration and female sex
infants and younger children who do not respond to the usual therapies, identifying and removing a food allergen
Food allergy is not a common trigger for older patients.
In severe atopic dermatitis, 30% of patients may have a food allergy trigger; for moderate eczema, 15%; for mild, less than 10%
Other environmental exposures, such as dust mites