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Dermatitis - Coggle Diagram

- - - - Result of repeated physical trauma, manifestation of OCD
    - - Intial trigger is chronic venous hypertension
      - Associated with other signs of venous hypertension (Pitting edema, stasis purpura, varicose veins, ulcers,)
      - Scaly plaques with exudation, crusting, erosions
      - Managed with compression socks
    - - Coin shaped well demarcated on extremities that is very itchy
      - More chronic, often secondarily infected
      - DDx
        
        Tinea, Psoriasis
      - Treatment
        
        High potency corticosteroids, antibiotics if infected, phototherapy, short course of pednison
    - - Dry, Rough scaly, inflamed, cracked skin, frequent bathing, agign, dryness, low humidity
    - - Special vesciular type of hand/food dermatitis, sudden onset, deep seated pruriitis vesciles, secondary bacterial infection
    - - Sebum + Malassezia furfur years
      - Infantile form in first 3 months of life, Adult form 5% prevalence
      - Scalp, Ears, Face, symmetric, well demarcated, pink-yellow to red-brown, greasy scales, pruritis
      - Infantile: Gentle skin care, topical ketoconazole if severe
      - Adult: Anti fungal shampoo or cream, low potency corticosteroid may be needed
  - - - Inflammation of cutaneous surface resulting from interaction of skin with chemical or physical agent
      - Types
        
        Irritant Contact dermatitis
        
        Allergic Contact Dermatitic
        
        Type 4 cell mediated, delayed hypersensitivity reaction, papilovesciular and very itchy
        
        Contact urticaria
        
        Need to take history on onset, distribution, site, products used, work history, hobbies, exposures
  - - - Stimulates the release of pro-inflammatory cytokines, itch not from histmines, regulated by neuropeptides
    - - Easier access in dermatitis prone skin, promotes pruritis and inflammatory response
    - - Food, Environemnt
    - - Anti-microbial peptides are downregulated in atopic dermatitis
      - Increased bactreial adherence to eczematous skin
      - Staph Aureus Colonizaiton in >90% of atopic dermatitis patients
        
        Inflammatory response, amplify inflammatory, reactions, corticosteroid resistance
  - - - Antigen-Presenting Cells
        
        Langehans cells bearing IgE present allergens to Th2 cells and migrate to lymph nodes
        
        Inflammatory dendritic epidermal cells releases proinflmmatory signals when stimulated by IgE
        
        LEads to amplification of immune response
      - T-Cells
        
        Skin homing memory T cells
      - Keratinocytes
        
        Augment atopic skin inflammation
        
        Augment Atopic Skin Inflammation
    - - T Helper Type 2 cytokines, Mediate IgE immunoglobulins, IL-31 induces pruritis
    - - Jak Inhibitors, Act on multiple inflammatory pathways
- - - - High Pontency - Clobetasol
      - Medium Potency - Betamethasone valerate
      - Low Potency - Desonide 0.05% ointment
    - - Atrophy, Telangiectasis, Striae, Hypopigmentation, Purpura
  - - - No steroid side effects, safe for ongoign use
    - - Burning with intiial application, reacts with alochol/sun, cost, bllack box warning