Internal Medicine

P1: SBT

0521779407-05 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:49

188 Atopic Dermatitis Atrial Fibrillation (AF)

■Side Effects & Complications

■Emollients – irritation, contact allergy

■Topical corticosteroids – atrophy, contact allergy

■Ultraviolet light – sunburn, irritation, skin cancer (long-term use),

and nausea and vomiting with psoralens typical side effects of

immunosuppressive agents

follow-up

■During Rx, monitor for irritation from topicals or side effects from

systemic medications

■Topical corticosteroids – monitor progress, evaluate for atrophy/

irritation

■Systemic corticosteroids

■Long-term use – complete physical exam, ppd, chest X-ray, blood

sugars periodically, blood pressure, and eye exam

complications and prognosis

This tends to be a life-long condition with exacerbations and remissions

that tend toward slow resolution with age.

Atrial Fibrillation (AF).................................

EDMUND C. KEUNG, MD

history & physical

History

■Chronic or paroxysmal

■Remodeled atria from rheumatic, coronary, hypertensive, congenital

heart disease; mitral valve prolapse

■Occurs in 5–40% post-coronary artery bypass operations; 70% on

day 2 and 3 postop

■Acute alcohol intake (“holiday heart”)

■Heart disease absent (lone atrial fibrillation)

■Increases with age (from 1.5% at age 60 to 10% at age 80)

■Irregularly irregular pulse. Variable first heart sound intensity

inversely related to the preceding cycle length.

Signs & Symptoms

■No symptoms or palpitation; irregularly irregular tachycardia and

pulse