1. دکتر افشین شیرکانی فوق تخصص آسم و آلرژی و بیماری های نقص ایمنی عضو آکادمی آسم و آلرژی و ایمونولوژی آمریکا استادیار دانشگاه

4.  MAJOR FEATURES : Pruritus (the most important) Facial and extensor eczema in infants and children Flexural eczema in adolescents Chronic or relapsing dermatitis Personal or family history of atopic disease

5.  >10% of infants  90% onset before age 5  Atopic march: >50% of patient develop asthma or other allergy

6.  Genetics(fillaggrine mutation),Environment: Skin barrier damage IgE to Staphylococcus aureus toxins, Superantigen stimulation causes Treg lose suppressive activity A decrease or absence of antimicrobial peptides  Acute: IL-4, IL-13  Chronic: IL-5, IL-12, IFN-γ

8. 1.Older children and adults have lichenification of flexor surfaces including:  Hands  Feet  Face  Antecubital and popliteal fossa 2.Infants have involvement of:  Extensors  Neck  Trunk  Face  Spares nasolabial skin fold

9.  Skin biopsy can be useful in patients who do not respond well to corticosteroids  Patch testing is useful in patients with suspected contact allergen such as nickel or cosmetics  SPT for identifying aeroallergen triggers such as: Dust mites Animal dander Weeds Molds

10. Patch tests

13.  Staphylococcus aureus  herpesKaposi(varicelliform eruption or eczema herpeticum )  molluscum contagiosum, papillomavirus (warts)  Malassezia furfur, and Pityrosporum ovale.  Eczema Vaccinatum (smallpox vaccination)  Anterior cataracts are associated with Atopic keratoconjunctivitis.  Posterior cataracts are associated with Prednisone

14.  Food (milk, egg, soy, wheat, fish, peanuts, and tree nuts)  Aeroallergens( Dust mites, Animal dander, Weeds, Molds)  Autoantigens  Microbial Agents and Toxins

20.  Cutaneous hydration and emollients  Topical corticosteroids:  Topical calcineurin inhibitors  Avoidance of triggers of AD  Antihistamines to control itching.  Novel treatments include Vitamin D  Immunotherapy for aeroallergen