Dermatology for the allergist - Twitter summary from 2012 #AAAAI meeting

This summary was compiled from the tweets posted by the following allergists/immunologists who attended the 2012 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI): Nathaniel Hare M.D. @AllergyTalk. The tweets were labeled #AAAAI. The text was edited and modified by me.

Here some excerpts from the lecture Dermatology for the allergist by Dr Beltrani:

With age, skin becomes flatter and has less vasculature.

Eczema (Atopic Dermatitis, AD)

Eczema (AD) is usually perivascular and responds to steroids.

Soap in AD makes skin break down faster. Avoid soap. It is best to use non-soap cleansers. They usually do not contain sodium lauryl sulfate (SLS), a chemical that creates soap’s foaming action and can dry and irritate skin. Non-soap cleansers include Dove Sensitive Skin Unscented Beauty Bar, Aquaphor Gentle Wash, Aveeno Advanced Care Wash, Basis Sensitive Skin Bar, CeraVe Hydrating Cleanser, and Cetaphil Gentle Cleansing Bar.

AD has been linked to more than 55 gene abnormalities, including poor ceramide production - adding ceramide can help but does not cure AD. Drier skin may have worse prognosis in AD.

Papule is a raised lesion. A plaque is a papule that is bigger than 1 cm. Eczema is papulosquamous.

Bulla is a giant vesicle. Contact dermatitis is Th1 disease. Eczema is Th2 disease. Th2 diseases doe not produce bullae.

If kids do not respond to standard therapy for eczema, expand differential diagnosis and consider a lot of primary immunodeficiency disorders (PIDDs) ( hyper IgE, Netherton, agammaglobulinemia), scabies, contact dermatitis, PKU, etc.

1/3 of patients with moderately-severe AD have food sensitivities.

Consider providing a written action plan for AD.

Apple cider vinegar in bath water

You can use apple cider vinegar in bath water instead of bleach for AD. It may have antifungal activity as well compared to bleach. Apple cider vinegar may also help skin because it is acidic.

Dosing in bath for bleach or apple cider vinegar: start at 1/2 cup per entire bath, target:1 cup per bath as tolerated.

Urticaria (hives)

50% of hives resolve in 1 year on their own.

Wheal (hive): if there is neutrophilic infiltrate on biopsy, it will not respond to oral antihistamines. Remember that not all hives are IgE-mediated.

In leukocytoclastic vasculitis: always check UA, as kidneys are often involved.

Allergists achieved highest use of social media by any specialty

During the 2012 AAAAI meeting, the allergists achieved the highest use of social media by any specialty. There are more than 100 allergists on Twitter and 30 of them posted simultaneously from the annual meeting, broadcasting thousands of tweets tagged with #AAAAI. The annual AAAAI meeting was attended by approximately 5,000 people. In comparison, the 30 allergists on Twitter reached 250,000 people (measured by TweetReach.com on 03/04/2012).

This summary was compiled from some of the tweets posted by Nathaniel Hare M.D. @AllergyTalk. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.

Disclaimer: The text was edited, modified, and added to by me. This is one of a series of posts that will be published during the next few weeks.

Comments from Twitter:

AllergyNet Dr John Weiner: @Allergy We are so grateful for these summaries. Thank you, Ves #AAAAI