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 Atopic Dermatitis

• the first symptoms  infancy

• 50% of cases diagnosed by 1 year of age.
• 1/3  persistent disease throughout adulthood

 Eczematous skin lesions

 Dry skin
 Intense pruritus
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 The prevalence of atopic dermatitis

•   in recent decades.
• In developed countries ± 10-15%
of children  5 years.
- Australia 5 years 30 %
- Singapore 7 years 22.7 %
- Sweden 5 years 20.7 %
- RSDS - Sby 5 years 11.2 %

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Clinical features
• Infantile phase ( 0 - 2 years )
• Childhood phase ( 2 -12 years )
• Adolescent phase ( 12-18 years )

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 Infantile phase

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 Childhood phase
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Adolescent phase

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 Diagnosis
Min 3 kriteria mayor + 3 kriteria Minor

Mayor :
Pruritus
 Morfologi dan distribusi khas
Dermatitis Kronis dan residif
Riwayat Atopi

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 Kriteria Minor :
 Xerosis, iktiosis, reaksi tes kulit tipe I, kadar IgE
naik, infeksi kulit, dermatitis pada tangan,
dermatitis puting susu, cheilitis, konjungtivitis
rekuren, lipatan infra orbital Dennie Morgan,
keratokonus, katarak subkapsular anterior,
daerah bawah mata warna gelap, kepucatan
dan kemerahan pada muka, pitiriasis alba,
lipatan pada leher depan, gatal waktu
berkeringat, intoleran terhadap wool, white
dermographisme, perjalanan penyakit
dipengaruhi faktor lingkungan dan emosi

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Non lesion Anatomy Skin lesion

Eczematous
Dry skin
Lichenification

Subclinic Dermatitis
Dermatitis Inflammatory cell

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 Problems :

 Etiology  Prevalence 
 Pathogenesis  Recurrence
 Diagnosis  Response to environment
substance

Management Quality of life

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 CLINICAL ASPECT

Eczematous
lesion

Pruritus AD Infection

Xerosis

MANAGEMENT
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Pathophysiology

BIOCHEMICAL

EPIDERMAL BARRIER GENETIC IMMUNE

disturbance predisposition dysregulation

ENVIRONMENTAL
allergens
TRIGGER FACTORS :
 Irritation
 Food
 Aero allergen
 Infection
 Emotional stress Chronic
 Etc. exacerbation
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Persistent skin inflammation
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 Atopic Dermatitis
Current Management

• No cure for atopic dermatitis

• Symptomatic disease adapted treatment
 Education
 Adjuvant basic therapy
 Disclosure and avoidance of trigger factors
 Anti-inflammatory measurements

Symptomatic relief of eczema and pruritus

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The short-term needs
in atopic eczema

Relief of :
Pruritus
Sleeplessness
Eczema signs

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 Other treatment options
systemic corticosteroids
other pharmacological interventions such as
cyclosporine or azathioprine.
sedating antihistamines
intermittent use of topical and oral antibiotics
phototherapy
counseling  psychological impact.
'alternative' therapies ; Chinese herbal

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