1. Dermatitis Atopik
2. Dermatitis Kontak
3. Dermatitis Numularis
4. Dermatitis Seboroik
5. Dermatitis Statis
6. Eczema Infantum
7. Neurodermatitis
( Likhen Simpleks Kronikus)
8. Dermatitis Tangan & Kaki
made wardhana
Atopic dermatitis (AD) or atopic eczema is a
• Chronically relapsing, pruritic, skin inflammation
• Characterized primarily by an allergic diathesis
• IgE mediated sensitization to environment allergen
• Sometimes first appears in infancy.
• Spesific clinical features: infant, child and adult
Prevalence
• Doubled or tripled in industrialized
countries during the past three
decades;
• 15 to 30% of children and 2 to 10% of
adults are affected.
• Atopic dermatitis frequently starts in
early infancy (early- onset atopic
dermatitis). in adults (late-onset atopic
dermatitis).
• 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.
Etiology
• The etiology of AD has not been fully
unknow
• Hereditary/genetic and environmental
factors
Pathophysiology - Immunopathogenesis
• Hyperactive Th2 subset Thelper cells (associated with
promotion of IgE production from B lymphocytes,
differentiation of CD-4 T lymphocytes, suppression of Th1
cell activities, stimulation of proliferation, and
differentiation of B lymphocytes)
• Increased levels of serum IgE
• Upregulation of IL-4
• Increased eosinophils
• Elevated levels of IgE activated mast cells
• Disturbances in fatty acid metabolism/deficiencies of omega-6
fatty acids in plasma, adipose tissues, and formed blood
elements
Mediators of Mast Cells and Allergy
AllergyChula
Clinical Feature
The natural history of the illness may be described under the
different age groups:
1. Infancy (2 mo – 2 yr)
Cheek & others, symetrical, erythem macule, papulo-vesicle
‘oozing’, moist crust
2. Childhood (> 2 y)
antecubital and popliteal fossae, symetrical
less exudattive, drier and more papular , Lichenified, slightly scaly
• Moisturizers
• For mild flare, mild (class VI or VII) corticosteroid
to affected areas twice daily
• For severe eczema, short term (no more than 2 wk)
of medium- to high-potency topical
corticosteroids (class III through V)
• Oral antibiotics for widespread, infected, flaring
eczema
• Topical antimicrobials, including mupirocin, bacitracin,
3% precipitated sulfur in petrolatum, 1%
hydrocortisone, applied twice daily for infected
eczema of the trunk and extremities
• Antihistamines for pruritis
• Eliminate precipitating environmental factors
Contact dermatitis refers to dermatitis caused by
skin contact with an environmental agent.
Contact dermatitis (CD) is an altered state of skin
reactivity induced by exposure to an external
agent.
• orang dewasa
• Penyebab ???
• Faktor stres
• Garukan yang berulang-ulang di suatu tempat
pergelangan, tangan, kuduk, betis
• Klinis : lesi kronis
hiperkeratosis, likhenifikasi,
hiperpigmentasi
• Terapi : cari penyebabnya
Steroid topikal kuat
Stasis Dermatitis
D Seboroika oleosa
Wajah, sternum, interscapula
skuama tebal berminyak (warna kuning)
Bayi baru lahir cradle cap : Leiner disease
Penatalaksanaan
Cari penyebabnya
Antihistamin
Topikal krim hidrokortison
Kulit kepala : sampo : selenium sulfida, ketokonazol
sulfur
Stres sedatif, penenang