Documente Academic
Documente Profesional
Documente Cultură
Nama
: Sumadiono, dr SpA(K)
Tempat/ tanggal lahir
: Nganjuk, 9-10-1956
Pekerjaan/jabatan : Staf Bagian Ilmu Kesehatan Anak FKUGM
Riwayat pendidikan formal:
Dokter umum
: Fakultas kedokteran Unair, lulus tahun 1982
Spesialis anak
: Fakultas kedokteran UGM, lulus tahun 1994
Konsultan Alergi Imunologi Anak: Ikatan Dokter Anak Indonesia 2002
Riwayat pendidikantambahan:
Molecular Biology (ICMR Kobe, Japan, 1996)
Basic Immunology (VU Amsterdam, The Netherland, 1997)
Pediatric clinic/treatment (VU Amsterdam, The Netherlands, 1998 & 1999)
Pediatric Allergy Immunology (Saskatoon, Canada, 2003)
Medical Education: PBL (UM Mastrich, The Netherlands, 2004)
Trends in Medical Education (NUS, Singapore, 2004)
Workshop: Intraarticular Injection (IRA, 2005)
Riwayat Organisasi:
Kepala Sub Bag Alergi-Imunologi Bag. IKA FK UGM
Wakil Ketua Team Herbal RSUP Dr. Sarjito
Ketua Sub Komisi Evaluasi Proses Kolegium IDAI
Ketua Peralmuni Cab. DIY
Ketua UKK Alergi Imunologi IDAI
New Mechanisms in
Atopic Dermatitis
The Role of Emollients in its
Management.
Hugo Van Bever
Department of Pediatrics
Khoo Teck Puat CMI
NUHS - Singapore
ITCH
- Looks
- Sleep
- Study activities
Other symptoms
White Dermatographism
Catarak subcapsular
anterior
Xerosis/ichtyosis/
hyperlinear palm
Periauricular fissures
Cheilitis
Kepekaan infeksi kulit (Herpes/Strep/S aureus)
Pompholix
SCORing
Atopic
Dermatitis
(SCORAD)
index
Hi Suma,
For research it is better to use a more extensive
score, such as SCORAD.
However, for myself in my daily clinic I use:
- MILD (dry skin, few patches, but <5)
Atopic dermatitis
Genetic constitution
Environmental factors
(role of epigenetics)
atopy
skin barrier defects
allergens
- food
- inhalant
microorganisms
pollution
irritants
X2
Chronic skin
inflammation
Q: primary or second
AD = a syndrome (subty
Profilaggrin
(keratohyalin F granules)
Filaggrin
*Morar N, et al. J Invest Dermatol 2007; 127:1667-72; Cai S, et al. Br J Dermatol 2012; 166: 200-3
REFERENCES:
- CAI S.C., CHEN H., KOH W.P., COMMON J.E., VAN BEVER H.P., McLEAN W.H., LANE E.B., GIAM, Y.C., TANG M. B.
Filaggrin Mutations are Associated with Recurrent Skin Infection in Singaporean Chinese Patients with Atopic
Dermatitis. Br J Dermatol 2011, 1111, 1365.
- CHEN H., COMMON J. E., BALAKRISHNAN A., BROWN S.J., GOH C.S., CORDELL H.J., SANDILANDS A,, CAMPBELL
L.E., KROBOTH K., IRVINE A.D., GOH D.L., TANG M.B., VAN BEVER H.P., GIAM Y.C., McLEAN W.H., LANE E.B. Wide
spectrum of filaggrin-null mutations in atopic dermatitis highlights differences between Singaporean Chinese
and European populations. Br J Dermatol. 2011, 165, 106 - 114.
Loss-of-function variants
in the filaggrin gene are a
significant risk factor for
peanut allergy.
Brown SJ, et al.
JACI 2011, 127, 661 7.
Sensitization to food
- Prenatally
- Through breast milk
- Eating drinking
- Transcutaneous
(eczema)
- Inhaling - smelling
Role of allergy in AD
1. not always involved in AD
2. allergy in severe eczema
3. allergic sensitization can occur through the
skin
4. allergic sensitization can be a
HDM-allergy in AD
- skin inflammation (IgE-mediated)
- skin barrier disruption (HDM-proteases)
- increased cytokine production by
keratinocytes
Hypothetical Model of AD
1.
2.
3.
4.
HYPOTHETIC MODEL OF AD
early infancy
HYPOTHETIC MODEL OF AD
early infancy
Management of atopic
dermatitis
= A PACKAGE
(involving life style)
Cornerstones of treatment
of AD
1. Moisturizers
2. Topical
corticosteroids
3. Antiseptics
se
as
e
Step 4
Step 3
Dry Skin
Only
In
t
Mild to
moderate AD
en
s
it y
of
Di
Moderate to
severe AD
Systematic therapy
e.g. CyA/ UV therapy
Step 1
Step 2
Basic Treatment:
Skin hydration, emollient, avoidance of
irritants, identification and addressing specific
trigger factors
41
Moisturizers
A lot of mositurizers on the market
Most were not the subject of clinical
studies
Doctors confused!
MAS036P
MAS036P:
A unique, clinically proven (!), nonsteroidal flare remission treatment for
Atopic Dermatitis
Repairs
Protects
Calms (mild anti-inflammatory effect)
46
Glycyrrhetinic acid
Glycyrrhetinic acid
MAS063P - Key
conclusions
- Replenish skin moisture up to
72 hours
(Zhai, 2003)
General conclusion
1. AD is complex, involving many players
2. FLG best gene we have (more to
come)
3. Food allergy: new insights (role of the
skin)
4. Treatment: new approaches, including
preventing transcutaneous sensitization
Website:
www.apapari2014.com
Email:
admin@apapari2014.com
Contact person:
Asri Parantri, MD
+62-822 2623 8826
Secretariat:
Departement of Child Health
Faculty Of Medicine Gadjah Mada
University/Dr. Sardjito General
Hospital
phone-fax: +62 274
581088/5550045