Atopic Dermatitis

Atopic Dermatitis or eczema is a pruritic, chronic, and inflammatory condition that causes the skin to be red and itchy; it usually affects the face, arm, legs, and neck but spares the axillary region and groin. It is a chronic condition that remains in the body for years. It is common in children but can occur at any age. Atopic Dermatitis usually occurs along with hay fever and Asthma. Though Atopic Dermatitis is incurable yet possible, treatment and self-care measures can help a person get relief from the symptoms and prevent new outbreaks.

Types

Some of the common types of Atopic Dermatitis or eczema are the following:

• Contact dermatitis: In contact dermatitis, the irritation in the skin is caused due to continuous contact with the irritants.
• Neurodermatitis (lichenification): In the Neurodermatitis skin condition, thick patches appear on the skin due to continuous rubbing and scratching.
• Stasis Dermatitis: This skin condition develops due to poor blood circulation in the body, especially in the lower legs.
• Hand eczema: Hand eczema, also known as hand dermatitis, causes redness and itching in the hands due to continuous contact with irritant chemicals.
• Dyshidrotic eczema: In dyshidrotic eczema, sudden rashes usually appear in the palm, fingers, and soles of the feet.
• It is also known as discoid eczema or nummular dermatitis, which causes coin-shaped and itchy spots on the skin.

Causes

When the skin is healthy, it protects against allergens, bacteria, and irritants and keeps the body moisturized. Eczema is related to gene variation and change in a gene sequence, and it affects the skin’s ability to protect against allergens, irritants, and environmental factors. Food allergens are one of the main reasons behind eczema. Those kids with a family history of allergies, Asthma, and hay fever are more likely to suffer from eczema. Another reason for eczema is living in an area that is often cold or always remains polluted.

Atopic Dermatitis Symptoms

The symptoms of Atopic Dermatitis vary from man to man, but some of the common symptoms of Atopic Dermatitis are the following:

• Dry skin
• Scaly, cracked, and thickened skin.
• Severe itching, especially at night
• Darkening of the skin around the eyes
• Creasing of skin, especially on the palms of hands and under the eyes
• Sensitive and swollen skin due to scratching
• Rashes that bubble up and leak fluid
• Red or brownish patches in specific parts of the body such as on hands, ankles, feet, wrists, eyelids, upper chest, inside in the bent portions of knees and elbows, and on the scalp and face of infants

When to see a doctor

Immediately consult with the doctor if you notice the following conditions:

• An uncomfortable condition that causes insomnia and affects daily routine
• Skin infections such as red streaks and yellow scabs
• Continuous experience of the redness and itching on the skin despite using home remedies

One’s child is in critical condition if his rashes look infected or have a fever.

Atopic Dermatitis Diagnosis

During diagnosis, the doctor will examine the skin to notice the symptoms. He may ask several questions regarding the medical history, family history, and signs that a person is facing at that time. For proper diagnosis of the disease, he may order the following tests:

• Allergy skin test
• Blood test to know the actual cause of rash that may be related to dermatitis
• Skin biopsy to know the exact type of dermatitis that is present in the patient

Atopic Dermatitis Treatment

Though Atopic Dermatitis is untreatable, the doctors may suggest some medications to relieve the symptoms. Common medicines include steroid creams, ointment for mild flares, and steroids pills in severe cases.

Other methods of treatment include:

• Wet dressing
• Light therapy
• Use of antibiotics for bacterial infection
• Antihistamines to prevent itching at night
• Drugs that suppress the immune system, such as non-steroidal ointment, crisaborole (Eucrisa), and dupilumab(Dupixent)
• Injectable biologics are made up of protein that helps the immune system fight against germs and eases inflammation.
• Other skin creams

Lifestyle changes that help the adults to ease the symptoms are the following:

• Take a warm oatmeal bath for at least 10 minutes; antioxidants present in oatmeal help relieve itching and inflammation.
• Avoid scratching the skin; instead, put some pressure on that area where you feel itching.
• Moisturize the skin with oils and creams
• Use mild soaps that are free from fragrance and alcohol
• Use loose garments that don’t irritate the body, especially when in sweat
• Use a humidifier to moisture the air and prevent the skin from drying out

For kids, the following methods of treatment will be helpful to get relief from symptoms:

• Use baby oils and creams to keep the skin moist and avoid irritation
• Protect from extreme hot and cold temperature
• Avoid giving long and hot baths that can dry their skin
• Keep the room temperature as much as possible
• Use a cloth that does not irritate the baby’s skin, such as cotton, silk, or polyester
• Use mild soaps to avoid dryness
• Put gloves on their hands to prevent them from excessive scratching

Risk factors

Some of the risk factors that trigger Atopic dermatitis and make it worse are the following:

• Use of strong soaps and detergents
• Pollen and mold
• Animal dander
• Anger and stress
• Smoke of tobacco
• Low humidity and dry wind
• Sweat
• Dust and sand
• Skin infection
• Dry skin
• Certain hormones
• Keratin foods that cause allergies such as eggs, nuts, wheat, and other dairy products
• Perfumes and makeup
• Fabrics like wool or scratchy material

Complication

The complications of Atopic Dermatitis may include:

• Asthma and hay fever in children after the age of 13
• Discolored, leathery, and itchy skin that may look unappealing
• Skin infections that create open sores and cracks
• Allergic contact dermatitis and irritant hand dermatitis
• Difficulty in sleeping due to pain and itching

Preventions

Some of the following techniques and tips are useful for Prevent Atopic Dermatitis:

• Identify and avoid those allergens and triggers that cause itching and redness on the skin
• Take a regular bath of 10 to 15 minutes, neither too hot nor too cold
• Use gentle soaps
• Avoid excessive use of perfumes and makeup
• Use soft and comfortable fabric to wear
• Moisturize the skin daily to avoid dryness
• Only use those medications and creams that the doctor recommends
• Avoid pollution, cigarette smoke, and tobacco

Reference

• https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273#:~:text=Atopic%20dermatitis%20(eczema)%20is%20a,been%20found%20for%20atopic%20dermatitis.
• https://emedicine.medscape.com/article/1049085-overview
• https://nationaleczema.org/eczema/ types of eczema /atopic-dermatitis/
• https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-basics
• https://www.healthline.com/health/atopic-dermatitis/what-is-atopic-dermatitis#types
• https://my.clevelandclinic.org/health/diseases/9998-eczema