1. E. SUTEDJA DERMATO – VENEROLOGICA DEPT. MEDICAL FACULTY UNPAD
ATOPY and MORBIDITY
E. SUTEDJA
DERMATO – VENEROLOGICA DEPT.
MEDICAL FACULTY UNPAD

2. “ ATOPY “  GREEK “ WRONG PLACED”
What’s is atopy ??
“ ATOPY “  GREEK “ WRONG PLACED”
COCA & COOKE ( 1923 )
HEREDITARY DISORDER
INHERITED
HYPERSENSITIVE TYPE 1 (CLINICAL)
ENVIROMENTAL FACTORS
ASTHMA, HAY FEVER, ECZEMA, URTICARIA, AND FOOD ALLERGIES
HISTORY

3. HISTORY COCA & GROOVE (1925) ISHIZAKA (1966)
THE CAUSE  REAGIN IN SERUM
ISHIZAKA (1966)
THE REAGIN  IgE
HISTORY

4. DEFINITION AN INHERITED TENDENCY FOR HYPERPRODUCTIVE OF IgE ANTIBODY
TO COMMON ENVIROMENTAL ALLERGENS
TYPE 1 HYPERSENSITIVE, AN IMMUNOLOGIC REACTION WHICH PRODUCES TISSUE DAMAGE ON REEXPOSURE TO ANTIGEN
DEFINITION

5. PATHOPHYSIOLOGY INHERITED  GEN CHROMOSOME 5  IL4 (TH2)
CHROMOSOME 11q  IgE production
FILAGGRIN GENE : CHR 1q21 ( GENE MUTATION)  EPIDERMAL BARRIER DISFUNCTION  
PATHOPHYSIOLOGY

6. ENVIROMENTAL ALLERGEN
SKIN CONTACT
INJECTION
INGESTION
INHALATION
SHOCK BEE
POLLEN
TOXIC PLANTS
DRUGS
DRUGS
DUST
ANIMAL DANDER
NUTS & SEAFOOD
POLLEN
FUNGI
LATEKS
ANIMAL DANDER

7. PHATOMECHANISM

8. SYMPTOMS ATOPIC DISEASE( ATOPIC MARCH) NOSE RHINITIS ALLERGY
EDEMA & HYPERSEKRESI MUCOUS
VASCULAR
ANAPHYLAXIS
VASODILATATION
BRONCHIAL ASTHMA
LUNGS
MUSCULAR SPASME
ATOPIC DERMATITIS & URTICARIA
SKIN
VASODILATATION
INCREASE CAPILER PERMEABILITY
ATOPIC DISEASE( ATOPIC MARCH)

9. ATOPIC DEMATITIS “ ATOPIC ECZEMA “
FIRST ATOPIC MARCH
REDUCED SKIN LIPID LAYER > INCREASED TRANSDERMAL WATER LOSS > LOWERED RESISTANCE TO IRRITANT SUBSTANCES
ASSOCIATED WITH OTHER ATOPIC DISEASES
ASTHMA IN 30%
ALLERGIC RHINITIS IN 35%
CHILDREN
PREVALENCE 15-20%
75% GET IT BY 6 MOUNTH AND 80% START < 5 YRS
CLEARS IN 60% BY EARLY ADOLESCENCE
TYPICALLY EPISODIC – RELAPSE AND REMISSION
ATOPIC DEMATITIS “ ATOPIC ECZEMA “

10. ADULTS
PREVALENCE 2-10%
GENETIC COMPONENT – PRESENT IN 80% WHEN BOTH PARENTS AFFECTED AND 60% WHEN 1 AFFECTED

11. CLINICAL MANIFESTATION
THE ITCH THAT RASHES
The most common skin disorder seen in infants and children
60% present in first year of life
“Atopic March”: atopic dermatitis→food allergies→asthma→allegic rhinitis
Interruption of atopic dermatitis may↓incidence of asthma and allergic rhinitis
Characterized by exacerbations and remissions
CLINICAL MANIFESTATION
copyright pvernon 10-09

14. AN IMMUNE RESPONSE TO INHALED ALLERGENS
ALLERGIC RHINITIS

15. CLINICALLY DEFINED AS A SYMPTOMATIC DISORDER OF THE NOSE, INDUCED AFTER ALLERGEN EXPOSURE, BY AN IgE MEDIATED INFLAMMATION OF THE NASAL MEMBRANES
TYPE 1 IgE HYPERSENSITIVITY REACTION IN THE MUCOUS MEMBRANES OF THE NASAL AIRWAYS
IMMUNE RESPONSE OCCURING WITHIN MINS OF EXPOSURE TO ALLERGEN
INFLAMMATION OF THE NASAL MUCOUS MEMBRANE
ALLERGIC RHINITIS

16. CLINICAL FEATURES : Rhinorrhoea
Nasal irritation, itching, vestibulitis
Sneezing, ichy watery eyes
Long term nasal obstruction, anosmia, polyps

17. THANK YOU