A Family Doctor's Tale - ATOPIC DERMATITIS

DOC I HAVE ATOPIC DERMATITIS

This is a very common disease occurring especially in childhood and may be inherited.

My own granddaughter has very bad eczema during her first year .

It was made worse when she caught the chicken pox from her older sister.

Happily after the first year the skin recovered by itself.

Mild steroids like hydrocortisone may be applied in severe cases.


Atopic Dermatitis is a common skin condition which presents as a chronic, relapsing, and very itchy rash at some point during childhood.

Atopic Dermatitis clears and often disappears with age.

The causes of Atopic Dermatitis is unknown.

However some possible causes are:
1.Genetic

Genes play a part in Atopic Dermatitis as the condition runs in families

2.External causes

a.abnormal response of the body’s immune system play a part in the development of Atopic Dermatitis.

b.damage to the skin barrier may lead to dryness and inflammation of the skin

c.irritating substances overacts, causing itching and scratching.

Atopic Dermatitis is not contagious .



Atopic Dermatitis occurs in both children and adults, but usually appears during infancy.

1.Those who are genetically predisposed

2.Those exposed to environmental triggers

a.rough or coarse materials coming into contact with the skin causes itchiness.

b.feeling too hot and/or sweating will cause an outbreak.

c.certain soaps, detergents, disinfectants,

d.contact with juices from fresh fruits and meats,

e.food allergens in childhood such as cow's milk, hen's egg,peanuts, nuts, shellfish

f.dust mites,

g.animal saliva and faeces may trigger itching.

h.Upper respiratory infections (caused by viruses) may also be triggers.

i.Stress can also sometimes aggravate an existing flare-up.

Many people who have Atopic Dermatitis also suffer from Atopic rhinitis and asthma, or have family members who do.

Atopic Dermatitis affects both sexes equally.



Atopic Dermatitis can occur on just about any part of the body

In infants, Atopic Dermatitis typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

In children and adults, Atopic Dermatitis typically occurs on the face, neck, and the insides of the elbows, knees, and ankles.

In some people, Atopic Dermatitis may "bubble up" and ooze.

In others, the condition may appear more scaly, dry, and red.

Chronic scratching usually make the skin worse taking on a leathery texture because the skin thickens (lichenification).

Symptoms and signs of Atopic Dermatitis are:


Typical features of Atopic Dermatitis are:

1.dry,

2.red,

3.extremely itchy patches on the skin.

4.Oozing of the rash

5.Thickening of the skin

Atopic Dermatitis is diagnosed based on :


1.History and appearance of the rash

2.Screening test for food allergy

3.Blood test for specific antibodies to food substances



Treatment of an Atopic Dermatitis  is:

1. prevent scratching.

2. application of lotions or creams to keep the skin as moist as possible after bathing (within three minutes is a common recommendation) so that the moisture from the bath is "locked in."

3.Cold compresses applied directly to itchy skin can also help relieve itching.

4.application of nonprescription corticosteroid creams and ointments to reduce inflammation
if the condition persists, worsens, or does not improve satisfactorily.

Hydrocortisone cream and ointment are preferred to prevent side effects such as skin thinning.

5.For severe flare-ups, your doctor may prescribe oral corticosteroids (this treatment is not recommended for long-term use).

6.topical or oral antibiotics may be needed for the skin infection which may affect the dry inflamed skin.

7.sedative antihistamines are sometimes used to reduce the itch

8.Tar treatments can have positive effects; however, tar can be messy.

9.Phototherapy requires special equipment (lights).

10.cyclosporine A, which modifies immune response; however, this is used only in extreme cases because of its association with serious side effects.



Atopic Dermatitis outbreaks can usually be avoided with some simple precautions.

The following suggestions may help to reduce the severity and frequency of flare-ups:

Moisturize frequently

Avoid sudden changes in temperature or humidity

Avoid sweating or overheating

Dress the child in breathable cotton clothes

Reduce stress

Avoid scratchy materials (e.g., wool or other irritants)

Avoid harsh soaps, detergents, and solvents

Avoid environmental factors that trigger allergies (e.g., pollens, molds, mites, and animal dander)

Be aware of any foods that may cause an outbreak and avoid those foods