Apriyanti Muhammad 1102080003

Hatija Muliana 1102080041

Fhiqy Asjuwita 1102090005

Advisor : dr. Elfa Wirdani Fitri

Supervisor : dr.Hj.Sri Rimayani, Sp.KK
ATOPIC DERMATITIS
Defenition
Atopic dermatitis is a chronically
relapsing skin disease that occurs most
commonly during early infancy and childhood. It
is frequently associated with abnormalities in
skin barrier function and allergen sensitization.
Epidemiology
In USA, Europe, Japan, Australia prevalence
in children of 10%-20%, in adults is
approximately 1%-3%.
Female > male, ratio 1,3:1
A total of 45% of all cases of atopic dermatitis
begin within the first 6 months of life, 60%
begin during the first year, and 85% begin
before 5 years of age.

Etiologi
Atopic dermatitis is a highly pruritic inflammatory
skin disease that result from complex interactions
between genetic susceptibility genes resulting in a
defective skin barrier, defect in the innate immune
system and hightened immunologic responses to
allergen and microbial antigens.
Patogenesis

Atopic dermatitis
Decrease skin
barrier
Immunopathology
Citokin and
chemokin
Genetics
Reduced
ceramide levels
IgE
Th-2,IL-4,IL-
2,IL-10,IL-13,
Diagnose
Clinical feature : Itching, Macular erythema, papules or
papulovesicles, eczematous areas with crusting,
lichenification and excoriation, dryness of the skin.
Atopic dermatitis can be devided into three stages ;
Infantile (2 months to 2 years)
Children (2 10 years)
Adult

The diagnose is made when the patients has three or
more of the major criteria and three or more of the minor
criteria
Major criteria
(must have three of the following)
Minor criteria
(must also have three of the following)

Pruritus
Rash on face and/or extensor in
infants and young children
Lichenification in flexural areas in
older children
Tendency toward chronic or
chronically relapsing dermatitis
Personal of family history of Atopic
dermatitis


Dryness
Tendency for cutaneous infections
(especially S.aureus)
Tendency to nonspecific hand/foot
dermatitis
Ichthyosis
Pityriasis alba
Nipple dermatitis
White dermographisme and delayed
blanch response
Cheilitis
Dennie Morgan fold
Conjunctivitis
Keratoconus
Minor criteria
(must also have three of the following)
Anterior subcapsular cataracts
darkening beneath the eyes
facial pallor
Itch when sweating
Intolerance to wool and lipid solvent.
Perifollicular accentuation
Food hypersensitivity
Course influenced by environmental
and/or emotional factors
immediate skin test reactivity
elevated serum IgE
early age onset
Cont..
Infantile Atopic Dermatitis

Efflorescence :
papulo-vesicles, exudate,
crusts

Predilection :
forehead,cheek, skalp, neck,
wrist, lower and
upper extremity.

Efflorescence :
dryness, exudate, crusts,
papules, lichenification,
scaly skin, erosions
Predilection :
antecubital and popliteal
fossae, fleksor wrist, eyelids,
around the neck, rare on the
face

Childhood Atopic
Dermatitis
Adult Atopic
Dermatitis

Efflorescence
Plaque papular-eritematosa,
scaly skin, lichenification

Predilection :
antecubital and popliteal
fossae, neck, forehead,
around the eyes
Differential Diagnose
Seborheic Dermatitis:
the eruption consists of
confluent papules and
erythema with an
orange hue and slight
scaling
Nummular Eczema:
A large asymmetrical
plaque with vesicles,
erosions, and crusts

Psoriasis:
The sparing in the
center of the palm
and the sharp
delineation
Cont..
Contact Dermatitis:
erythema, papulation,
vesiculation, and crusting
Scabies:
Papules and burrows in typical
location on the finger web
Treatment
1. Non Pharmacologic
2. Pharmacologic :
Topical Therapy
Skin Hydration : Urea Hydrofilic 10% +
Hydrocortison 1%, Emolient
Topical Corticosteroid : Hydrocortison 1-2,5%
(infant), Triamnosolon ( child & adult)
Tar preparation
Topical Antihistamin : topical 5% Doxepin (1
week)
Cont
Systemic therapy
Corticosteroid
Antihistamine : Hidroxyzine or
Diphenydramine.
Antibiotic: Erytromicine,
Cephalosporin

Prognose
Periods of remission appear more frequently as
the patients grows older
Spontaneous resolution of Atopic Dermatitis has
been reported to occur after age 5 years in 40-
60% of patients affected during infancy,
particularly if their disease is mild.
30-50% will be develop into asma broncial and
hay fever

Thank You