Atopic Dermatitis
Atopic Dermatitis, a chronic disease that affects the skin, is often called eczema. It is very common, with as many as 20% of all infants and young children experiencing symptoms. Many do not continue to experience symptoms when they reach adulthood. However, it is estimated that 15 million people have symptoms of atopic dermatitis.
Defining Atopic Dermatitis
The word "dermatitis" means inflammation of the skin. Atopic refers to a group of diseases that have an inherited tendency to develop other allergic conditions, such as asthma and hay fever. Although atopic dermatitis may occur at any age, it occurs most often in infants and children.
The cause of atopic dermatitis is unknown, but seems to result from a combination of heredity and environmental factors. Children are more likely to develop the disorder if one or both parents have or have had allergic conditions. While children sometimes outgrow skin symptoms, they often go on to develop hay fever or asthma. Environmental factors can bring on symptoms of atopic dermatitis at anytime in someone who has inherited the disease trait.
Atopic dermatitis is associated with a malfunction of the immune system. People with atopic dermatitis have a low level of a cytokine (a protein) and high levels of other cytokines that lead to allergic reactions. The immune system attacks what it perceives to be an intruder and creates inflammation in the skin, even though there is no infection. Stress, anger, and frustration make the disease worse, but these factors do not cause the disease.
Other factors, such as irritants that directly affect the skin, such as frequent wetting and drying, wool or synthetic fibers, rough clothing, soap and detergents, and cigarette smoke, cause the condition to be worse. Allergens, such as food, plants, animals and things in the air can inflame the skin when the immune system overreacts.
Symptoms
Symptoms of atopic dermatitis vary, but the most common one is dry, itchy skin and rashes on the face, inside the elbows and behind the knees, hands, and feet. It may also affect the skin around your eyes, eyelids, eyebrows and lashes. People suffering from atopic dermatitis may develop extra folds of skin under their eyes and patches of hair loss.
Scratching or rubbing the area irritates the skin and increases the inflammation and the itchiness. Depending on how much scratching takes place, and secondary infection to the area, your skin may be red and scaly, thick and leathery, leaking fluid, crusty and infected with small raised bumps.
Research has shown that the skin of a person with atopic dermatitis loses moisture from the epidermal layer of the skin, allowing skin to become dry and reducing its protective ability.
Diagnosis
Diagnosis is based on past experience, medical history, and several visits to the doctor during which other diseases and conditions are ruled out. The doctor may administer a skin prick test to determine which allergens are causing your problem. You may be referred to a dermatologist who specializes in skin disorders or an allergist for evaluation.
Treatment
Treating atopic dermatitis is a team effort, including the doctor, family, and patient. The doctor devices a plan and the parent's role is to support the patient in following the doctor's instructions.
Medications that may be recommended:
- Immuno-modulators - help control inflammation and reduce immune system reaction.
- Patients older two - Corticosteroid creams and ointments could be over-the-counter medication. If topical corticosteroids don't work, could prescribe systemic cortisone typically only short.
- Antibiotics to treat skin infections.
- Antihistamines.
- In adults drugs to suppress immune system if other treatment has failed.
- Phototherapy - use of ultraviolet waves.
Skin routine may inclue:
- Lukewarm baths.
- Using mild soap.
- Pat dry or air dry and apply lubricant to seal water that has been absorbed during bath. Avoid lotion with high water or alcohol content.
- Identify allergens and reduce exposure to allergen.
- Keep fingernails short.
- Select cotton fabrics.
- Keep child cool; avoid overheating.
- Learn to recognize skin infection and get treatment.
- Distract child from scratching.
- Talk with your doctor about medication that will promote sleep and reduce scratching at night.