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Dermatologists and Skin Care Data Verified

Atopic Dermatitis - a Chronic Relapsing Skin Disease

Written by
Dr. Suvash Sahu
and medically reviewed by iCliniq medical review team.

Published on Dec 05, 2016 and last reviewed on Sep 07, 2018   -  2 min read

Abstract

Atopic dermatitis is a chronic disease, which usually manifests for the first time in infancy or childhood. But, it usually improves with age.

Contents
Atopic Dermatitis - a Chronic Relapsing Skin Disease

Atopic dermatitis is an endogenous eczema (eczema due to internal causes) characterized by extreme itchiness and recurrent symmetric eczematous dermatitis. The involvement of a site depends on the age of the patients. This chronic eczema is one of the atopic conditions and together with asthma and hay fever, it has a heritable tendency. Certain environmental factors like winter, inhaled allergens and certain food may aggravate this disease in a certain subset of patients. Its clinical course and features vary with age and are easily aggravated by secondary infections. Herpes simplex viral infection can cause a very severe rash called as Kaposi varicelliform eruption in children with atopic eczema.

Clinical Features

Three distinct patterns of atopic dermatitis have been recognized depending on the patient's age:

  1. Atopic dermatitis in infancy.
  2. Childhood phase.
  3. Adult phase.

Atopic Dermatitis in Infancy (Infantile Eczema)

Atopic dermatitis in babies begins after the age of 3 months. Lesions are intensively itchy papules and vesicles, which soon discharge serous fluids. Lesions begin on the face, but can involve the rest of the body. But, usually, there is sparing of the diaper area and secondary infection is common.

Childhood Phase

Dry, leathery and extremely itchy, raised areas (plaques), mainly on the elbow and knee flexors. Sometimes, a reversed (extensor) pattern may be seen.

Adult Phase

Lesions are very itchy and lichenified, looks like tree bark. It involves the cubital (front of the elbow) and popliteal fosse (back of knee) and sometimes the neck. A low grade involvement may be seen on the rest of the body. Discoid pattern (coin shaped) of eczema may be seen.

Treatment

General Measures:

Topical Therapy:

  1. Moisturizers - Emollients are used to alleviate itching due to dry skin. Emollients can be added to the bath or applied directly to the skin.
  2. Topical steroids - These are used for localized exudative lesions and sometimes in combination with topical or systemic antibiotics to prevent secondary infections if any. Topical macrolactam immunomodulators like Tacrolimus and Pimecrolimus are the latest topical agents for atopic dermatitis.

Systemic Therapy:

Systemic antibiotics are used in patients with extensive infected lesions. Systemic steroids with the availability of potent topical steroids and systemic corticosteroids have reduced the eczema substantially.

Antihistamines:

Especially, the sedating ones are used regularly to overcome the itching and are of great value in whom sleep is interrupted.

Counseling and Psychotherapy:

Not only can stress aggravate atopic dermatitis, but the severely affected child is also a source of stress for the whole family. Counseling is an important part of the treatment. Counseling of parents for do’s and don’ts when the patient is a child will help them lead a stress-free life. Adolescents with atopic dermatitis should be well advised that this disease often improves or goes into remission with ages. They should avoid occupations such as car mechanics, engineering, hairdressing or nursing.

For further information regarding atopic dermatitis consult an atopic dermatitis specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/atopic-dermatitis

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Frequently Asked Questions


1.

What Can Cause Atopic Dermatitis?

Atopic dermatitis is the inflammatory condition of the skin. The common causes of atopic dermatitis are allergens, hereditary or environmental factors. In many children, food allergens play a role in causing atopic dermatitis. When it is due to hereditary, genetic mutations can affect the skin and make it lose its capacity to retain moisturize.

2.

What are the treatment options for Atopic Dermatitis?

- Moisturize your skin twice a day.
- Apply topical corticosteroid creams.
- Apply an anti-itching cream to the affected area.
- Take an allergy or anti-itching medication.
- Wet wrap therapy.
- Phototherapy.
- Do not scratch.
- Apply bandages to avoid scratching.
- Use mild soaps.
- Take a warm bath.
- Use a humidifier.
- Wear loose and cotton garments.

3.

How Does Atopic Dermatitis Look?

Atopic dermatitis looks like small red bumpy, scaly, or swollen with cracked skin, which is often itchy. Clear fluids may come out of the bumps, and these bumps can dry and form a crust.

4.

How Long Does It Take for Atopic Dermatitis to Heal?

Atopic dermatitis can often last for weeks, months, or even years. It may occur in children younger than 12 months, and may last for their lifetime, or with occasional flare-ups, or improve with age.

5.

Can Atopic Dermatitis Go Away Completely?

There is no cure for atopic dermatitis, but self-care measures and proper treatment can relieve itching and further complications. The rashes in atopic dermatitis tend to flare-up or go away, but it will come back again.

6.

What Food Should You Avoid When You Have Atopic Dermatitis?

The foods you should avoid when you have atopic dermatitis are:
- Eggs.
- Dairy products.
- Citrus fruits.
- Wheat or gluten.
- Soy.
- Tomatoes.
- Spices such as cinnamon, cloves, and vanilla.
- Nuts.

7.

Can Atopic Dermatitis Be Itchy?

Atopic dermatitis can cause extreme itching and the skin looks very dry. The more you scratch, the more red, swollen, and sore, it will become. Scratching also results in new bumps or lesions.

8.

What Are the Triggering Factors of Atopic Dermatitis?

The factors that trigger atopic dermatitis are:
- Strong soaps and detergents.
- Some fabrics, like scratchy materials or wool.
- Perfumes, skincare products, and makeup.
- Pollen and mold.
- Animal dander.
- Tobacco smoke.
- Anger and stress.
- Dry winter air or low humidity.
- Long and hot showers or baths.
- Dry skin.
- Sweating.
- Skin infections or dehydrated skin.
- Certain hormones.
- Sand or dust.
- Certain foods like eggs, wheat, dairy products, soy, and nuts.

9.

How Can Atopic Dermatitis Be Treated in Adults?

When atopic dermatitis does not respond to local over-the-counter medications, it needs proper treatment with the physician's help. It cannot be cured completely but can be controlled with appropriate treatment. The following are the treatment options for atopic dermatitis:
1. Topical corticosteroid creams and ointments.
2. Tacrolimus and Pimecrolimus ointments.
3. Crisaborole.
4. Dupilumab.
5. Oral antibiotics.
6. Antihistamines.
7. Phototherapy.
8. Systemic corticosteroids.

10.

Can Atopic Dermatitis Spread From One Person to Another?

Atopic dermatitis is not contagious, meaning, your skin is not infected or unclean. You will not spread the condition if someone touches the affected skin. It can be well treated and managed with various treatment options and medications.

11.

How Can Atopic Dermatitis in the Face Be Treated?

The face skin can be rehydrated with emollients like petroleum jelly and topical steroids to reduce inflammation and itching. As scratching due to itching can worsen the condition and give way to new outbreaks, itching should be treated with antihistamines.

12.

How to Get Rid of Atopic Dermatitis Naturally?

The natural methods to get rid of atopic dermatitis are:
- Application of coconut oil to moisturize the skin and protect from bacteria, sunflower oil to reduce inflammation, and Cardiospermum oil to relieve itching.
- Different types of baths, like oatmeal baths, baking soda baths, bleach baths, vinegar baths, and bath-oil baths can also be used.

13.

Can a Child Outgrow Atopic Dermatitis?

Some children may outgrow atopic dermatitis and gradually improve as they grow, but others may take it to adulthood. Many are better by the age of 3, and others may have occasional troubles.

Last reviewed at:
07 Sep 2018  -  2 min read

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