Download Free Medical Atopic Eczema PowerPoint Presentation

Atopic Eczema PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : This medical presentation titled ""Atopic Eczema"" tells us about atopic eczema, its classification, chronic eczema, its exacerbating factors and clinical features, and its Treatment.

Tags : Allergy, pruritus, erythema, vesiculation, Chronic eczema, pruritus, xerosis, lichenification, hyperkeratosis, fissuring, Atopic dermatitis, Pathogenesis, Exacerbating factors, Itch-Scratch cycle, Discoid eczema, Seborrhoeic, Seborrhoeic eczema, Lichen simplex, Pompholyx, Follicular, Contact dermatitis, exogenous, Allergic, irritant, Complications, Treatment, steroid

Published on : Apr 24, 2021 | Views : 3000 | Downloads : 23

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Atopic Eczema Sharon Wong Suzy Tinker
Slide 2-

Classification Endogenous vs Exogenous Acute vs Chronic
Slide 3-

Acute eczema Acute: pruritus, erythema, vesiculation
Slide 4-

ppt slide no 4 content not found
Slide 5-

ppt slide no 5 content not found
Slide 6-

Chronic eczema Chronic: pruritus, xerosis, lichenification, hyperkeratosis, +/- fissuring
Slide 7-

Chronic eczema
Slide 8-

Eczema – clinical subtypes Irritant contact dermatitis Allergic contact dermatitis Atopic Discoid Seborrhoeic Venous Pompholyx Asteatotic Follicular/papular Exogenous Endogenous
Slide 9-

Atopic dermatitis Chronic relapsing skin disorder (prevalence 20%) Onset <5 years in 80% 40-60% remain symptomatic as adult 85% ↑ IgE, 80% associated with asthma/allergy Family Hx of atopy
Slide 10-

Pathogenesis of AD Interaction of skin barrier, genetic, environmental, pharmacologic, and immunologic factors Release of vasoactive substances from mast cells and basophils, that have been sentitized by the interaction of the antigen with IgE.
Slide 11-

Exacerbating factors Inhalants (dust mites, pollens) Infections Autoallergens (IgE) Foods (eggs, milk, peanuts, soy-beans, fish, wheat) Contact irritants (wools) Season (improves in summer, flares in winter) Emotional stress
Slide 12-

Clinical features
Slide 13-

Atopic eczema
Slide 14-

ppt slide no 14 content not found
Slide 15-

ppt slide no 15 content not found
Slide 16-

ppt slide no 16 content not found
Slide 17-

ppt slide no 17 content not found
Slide 18-

ppt slide no 18 content not found
Slide 19-

ppt slide no 19 content not found
Slide 20-

ppt slide no 20 content not found
Slide 21-

The Itch-Scratch cycle Pruritus usually begins and causes itch sensation Scratch causes skin trauma and precipitates skin inflammation Chronic inflammation leads to lichenification
Slide 22-

Clinical variants
Slide 23-

Discoid eczema
Slide 24-

ppt slide no 24 content not found
Slide 25-

ppt slide no 25 content not found
Slide 26-

Seborrhoeic
Slide 27-

Seborrhoeic eczema
Slide 28-

ppt slide no 28 content not found
Slide 29-

ppt slide no 29 content not found
Slide 30-

ppt slide no 30 content not found
Slide 31-

ppt slide no 31 content not found
Slide 32-

Lichen simplex
Slide 33-

ppt slide no 33 content not found
Slide 34-

Pompholyx
Slide 35-

ppt slide no 35 content not found
Slide 36-

ppt slide no 36 content not found
Slide 37-

ppt slide no 37 content not found
Slide 38-

Follicular
Slide 39-

Contact dermatitis (exogenous)
Slide 40-

ppt slide no 40 content not found
Slide 41-

ppt slide no 41 content not found
Slide 42-

ppt slide no 42 content not found
Slide 43-

ppt slide no 43 content not found
Slide 44-

ppt slide no 44 content not found
Slide 45-

Allergic vs irritant Immunological Type IV hypersensitivity Lifelong Positive patch test Non-immunological Can affect anyone More common atopics
Slide 46-

ppt slide no 46 content not found
Slide 47-

ppt slide no 47 content not found
Slide 48-

Complications of Atopic Dermatitis
Slide 49-

ppt slide no 49 content not found
Slide 50-

ppt slide no 50 content not found
Slide 51-

ppt slide no 51 content not found
Slide 52-

ppt slide no 52 content not found
Slide 53-

ppt slide no 53 content not found
Slide 54-

ppt slide no 54 content not found
Slide 55-

ppt slide no 55 content not found
Slide 56-

Impact of Atopic Dermatitis Hinders social interactions Disrupts sleep Disturbs schooling Failure to thrive Affects entire family
Slide 57-

Treatment
Slide 58-

Aim To get the eczema under control Keep the eczema under control
Slide 59-

Basic stuff Avoid provoking factors (wool, bubble baths, soaps, perfumes) Avoid dryness: Bath oils (Oilatum, Hydromol, Aveeno, Dermol) Soap substitutes (Aqueous cream, Dermol) Emollients (500g in 2 weeks) Treat any infection Antihistamines Reduce inflammation
Slide 60-

ppt slide no 60 content not found
Slide 61-

Reduce inflammation Topical steroids Topical immunomodulators Oral prednisolone Oral immunosuppressives Phototherapy
Slide 62-

ppt slide no 62 content not found
Slide 63-

Topical steroids Ointments better than creams Learn 3 topical steroids I) Hydrocortisone ii) Eumovate iii) Betnovate/Elocon
Slide 64-

Common topical steroid myths Can’t apply to infected or broken skin Can’t use topical steroids for more than 1 week non stop Hydrocortisone topically can thin the skin Cannot use potent topical steroids on the face
Slide 65-

To get the eczema under control Apply steroid daily until skin is back to normal Then stop or wean down Continue emollients
Slide 66-

To keep the eczema under control Apply topical steroid immediately the eczema flares Consider maintenance Rx (eg Protopic) Eumovate >30g per month- baby- refer Betnovate>60g per month –child-refer
Slide 67-

Tacrolimus ointment Inhibits T cell activation & suppresses cytokine gene transcription Inhibits IgE-induced histamine release from mast cells and basophils Down-regulates high affinity IgE receptor on Langerhans cells
Slide 68-

Important instructions to patients Burning/stinging sensation following application which will spontaneously resolve Avoid application after a hot bath or shower Recommend adequate application of tacrolimus ointment, it is NOT a topical steroid Care in sun - long term immunosuppression???
Slide 69-

Particular indications for topical tacrolimus ointment Peri-ocular involvement Flexural involvement Facial involvement Requirement for maintenance treatment with moderately potent or potent topical steroids Presence of topical steroid-induced cutaneous atrophy or striae Pigmented skin
Slide 70-

Not winning? Compliance? Infected? Contact dermatitis Difficult eczema?
Slide 71-

Dressings & bandaging Dressings Wet wraps Comfifast, tubifast, dermasilk garments Over emollient / weak steroids Quality Nursing Care
Slide 72-

Phototherapy UVB/TLO1 Psoralen + UVA = PUVA Methoxypsoralen Topical or systemic Whole body or regional
Slide 73-

Systemic treatments Short courses prednisolone Ciclosporin Azathioprine Methotrexate Mycophenolate mofetil
Slide 74-

Steroid side effects - local Skin atrophy Telangiectasiae Acne Pigmentaion change ALL MORE MARKED IN FLEXURAL SITES!
Slide 75-

ppt slide no 75 content not found
Slide 76-

ppt slide no 76 content not found
Slide 77-

Steroid side effects - systemic suppression HPA axis cataracts growth suppression loss bone density diabetes cushings
Slide 78-

Take home messages Bath oils, soap substitutes and emollients - all stages/severity of eczema Use the most appropriate strength of steroid for the severity and site Steroids can be used for longer than a week – arrange follow-up to review and step down when skin improved Check compliance – ask how long a tube of steroid/pot of emollient lasts Prompt treatment of coexistent infection Assess severity by asking about sleep/school disturbance, weight/height gain (red book), mood, family dynamics