Allergy and Immunology
Review Corner

Chapter 86 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Drs. Bret Haymore, Walter Reed Army Medical Center; Soo Kim-Delio, Walter Reed Army Medical Center.

Chapter 86: Atopic Dermatitis

1. Select the answer that correctly lists three of the five major criteria for diagnosing atopic dermatitis according to the Hafkin and Rajka criteria.
A. Pruritus, xerosis, chronic or relapsing dermatitis
B. Pruritus, elevated IgE level, chronic or relapsing dermatitis
C. Pruritus, positive immediate-type allergy skin tests, chronic or relapsing dermatitis
D. Pruritus, personal or family history of atopic disease, chronic or relapsing dermatitis

2. Organism associated with predominantly head and neck distribution of atopic dermatitis.
A. Staphylococcus aureus
B. Trichophyton rubrum
C. Pityrosporum ovale
D. Streptococcus viridans

3. An adult who has eczematous dermatitis with no history of childhood eczema and without other atopic features would benefit from a skin biopsy to rule out this condition.
A. Scabies
B. Contact Dermatitis
C. Cutaneous T cell lymphoma
D. Seborrheic dermatitis

4. S. aureus toxin is thought to act as a superantigen and binds to this region of the TCR, outside of the region involved in antigen recognition.
A. Variable region of the alpha chain
B. Variable region of the beta chain
C. Constant region of the alpha chain
D. Constant region of the beta chain

5. Agent in topical corticosteroids that is frequently implicated in causing contact dermatitis.
A. Thimerosol
B. Tixocortol pivalate
C. Quaternium-15
D. Nickel sulfate

6. What percentage of atopic dermatitis typically manifest before the age of 5 years old?
A. 25 percent
B. 50 percent
C. 75 percent
D. 90 percent

7. What area is typically spared in atopic dermatitis during infancy?
A. Face
B. Scalp
C. Diaper area
D. Extensor surfaces

8. As part of the immunoregulatory dysfunction found in atopic dermatitis, Th2 cells have been found to have increased secretion of which cytokines?
A. IL-10 and PGE2
B. IL-4, IL-5, and IL-13
C. IFN- gamma
D. CD80/CD86

9. T-cell derived IFN-gamma was shown to increase what receptor on keratinocytes, leading to acantholysis?
A. CD80
B. CD86
C. CD23
D. CD95

Answers:
1. D, page 1562
2. C, page 1562
3. C, page 1562
4. B, page 1563
5. B, page 1570
6. D, page 1560
7. C, page 1561
8. B, page 1564
9. D, page 1565, also known as Fas receptor