Atopic dermatitis or atopic eczema
Atopic dermatitis is a chronic skin disease most common in small children. It occurs in 17% of all children. The disease is more common in children with asthma or allergic rhinitis. This is a chronic disease with exacerbations and remissions, usually beginning in infancy.
Appearance of symptoms compatible with atopic dermatitis in adults, in which there is no history of this disease in childhood is less common and should prompt the need to rule out other diseases.
The disease has acute and chronic lesions. Acute lesions of the disease are usually characterized as scaly over a background of red skin and skin cracks. The involved skin itches and sometimes there is pain. Chronic lesions are characterized by thickened skin, rough skin areas and highlighting of the natural skin lines. Infancy lesions are usually in the face, scalp and extensor areas of the extremities. In children, lesions commonly appear under the area of the buttocks. Starting from this age, the preferred location is the extremity skin folds (in the flexor side). Most important, the disease may involve the skin around the eyes, which needs prompt treatment to prevent permanent damage.
Persons affected by atopic dermatitis have a tendency to skin infections by bacteria, fungi and viruses. Sometimes, when in a flare, it is necessary to treat a secondary infection in addition to the treatment directed to atopic dermatitis.
Development of the disease is only partially understood. Among factors related to disease development are improper functioning of the immune system and skin structure defects. There is evidence that a number of environmental factors, such as house dust mites and sometimes certain foods can cause worsening of the disease. The typical allergy antibody, IgE, is usually increased in blood in patients with atopic dermatitis, but it is not a specific finding.
Atopic dermatitis treatment needs several interventions:
- Avoid exposure to skin irritants and substances that remove the natural lubrication of the skin, such as: soaps, detergents, chemicals. It is recommended to use instead of soaps, cleaning materials such as soapless soaps (cleansers) with neutral pH. It is important to make a shower immediately after sweating. It is recommended an extra rinse in the laundry to further remove the residues of detergent.
- Clothing: Clothing ventilation is recommended, preferably use cotton. It is important to wash all new clothes before first use and after prolonged storage.
- Avoidance of known allergic factors, it is recommended to discuss the need for evaluation of allergic factors with an allergist.
- It is very important to restore skin moisture: after a bath or shower prevent evaporation of the skin moisture by applying an oily preparation such as Balneum to all affected areas, as recommended by an allergist. Use also moisturizing creams without fragrances.
- During disease flares it may be necessary to treat with corticosteroid creams for a short term. It is important to limit the use of corticosteroid cream because after prolonged treatment irreversible changes in the skin may appear. Today there is the possibility of anti-inflammatory drug therapies that do not contain corticosteroids, which are suitable for the age group over two years (for example Elidel). Only in rare and severe cases, it may be necessary to use oral corticosteroids to achieve a remission.