Atopic dermatitis refers to the chronic and itchy skin condition which is more prevalent in children but can occur at any age. It is also known as eczema and atopic eczema.
People with atopic dermatitis often exhibit the “atopic tendency” which means that they develop all or some of the following conditions: atopic dermatitis, hay fever (allergic rhinitis), and asthma. These conditions also have genetic components and may run in the families (parent, sibling, or child may also be affected). A family history of eczema, asthma, and hay fever can help to diagnose atopic dermatitis in infants, especially.
Atopic dermatitis varies in appearance between individuals. From time to time, the majority of individuals with this condition have acute flares with red, inflamed, and sometimes with blisters, patches. In between the flares, skin appears normal or is affected by chronic eczema in the form of dry, thick, and itchy areas.
In infants younger than one-year-old, eczema is distributed in a large abundance. The skin appears as dry, scaly, and red with small scratch marks caused by baby nails. The cheeks of infants are the first place that is affected by eczema. The napkin area is usually unaffected due to moisture retention from nappies.
In toddlers and pre-schoolers, eczema becomes more localized and thickened. Eczema affects the outer side of joints, especially elbows, wrists, knees, and ankles. As the child becomes older, eczema starts affecting flexor surfaces of joints and less extensor surface is involved. The affected skin becomes dry and thickened due to constant rubbing and scratching.
School-age children exhibit a flexural pattern of eczema. Their elbow and knee creases are affected the most. Other susceptible areas may include neck, scalp, eyelids, and earlobes. Moreover, this age group can develop recurrent acute itchy blisters on fingers, palms, and feet. In most cases, eczema tends to improve with age and may clear up during the teenage years. However, the barrier function of the skin will never be entirely normal.
Adults with atopic dermatitis exhibit various patterns of eczema. Their skin is often more dry in comparison with affected children. Adults persist localized eczema which occurs on hands, eyelids, and flexures. Atopic dermatitis is a major contributor to occupational irritant contact dermatitis which usually affects hands that are quite frequently exposed to solvents, detergents, and water. Adults with hand dermatitis often have dry and thickened skin with blisters.
Atopic dermatitis affects approximately 15-20% of children. It is impossible to predict if eczema can be improved with time. The onset of atopic dermatitis is usually before 2 years old. It worsens between two and four years old and then tends to improve with age.
Certain occupations that involve domestic duties, hairdressing, farming, and cleaning are the sources of the exposure of various irritants and allergens, that aggravate atopic dermatitis. Patch tests are recommended to be done in order to identify the source of exposure.
Treatment of atopic dermatitis can take from several months to years. The general measures include reduction of exposure to trigger factors when possible, frequent usage of moisturizers, and application of topical steroids prescribed by the dermatologist.
In some cases, management of atopic dermatitis can include the following options: antibiotics, oral corticosteroids, Methotrexate, Cyclosporine, Mycophenolate Mophetyl, Dupilumab, antihistamines, crisabarole ointment, Pimecrolimus and Tacrolimus topically and phototherapy.
Centre for Medical and Surgical Dermatology offers unique and personalized laser treatment options for each patient with atopic dermatitis.
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