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WHAT IS ATOPIC DERMATITIS?

Oheneba Kwakye Omane
Oheneba Kwakye Omane

Atopic dermatitis is a persistent eczematous skin disorder that affects children. Atopic dermatitis is a hereditary condition. Atopic dermatitis patients have "super sensitive" skin and a lower tolerance for irritation. Atopic dermatitis is characterised by weeping, oozing plaques of extremely itchy skin. Itching is a common symptom of this condition. Atopic dermatitis manifests itself as thicker, raised plaques of scaling skin. Atopic dermatitis patients appear to have an erroneous immunological response. Atopic dermatitis is treated by re-hydrating the skin with emollients such as petroleum jelly and using topical steroids sparingly to minimise inflammation and irritation. Antihistamines taken orally may help stop the "itch-scratch" cycle. Oral antibiotics may be prescribed in some cases since secondary infections can worsen the rash.

Atopic dermatitis is a prevalent, typically chronic skin condition that affects a huge portion of the world's population. Asthma, inhalant allergies (hay fever), and chronic dermatitis are all linked to atopy, a kind of allergic hypersensitivity. The condition is known to have a hereditary component, and it is more common in affected families. The usual form and spread of the rash in a patient with a personal or family history of asthma and/or hay fever are among the criteria that allow a doctor to identify it.  

The term atopic comes from the Greek word atopic, which means "strange." The term dermatitis refers to skin inflammation. When referring to this condition, many doctors and patients use the term eczema. It's also known as neurodermatitis. The skin becomes extremely itchy and inflamed as a result of atopic dermatitis, resulting in redness, swelling, vesicle production (minute blisters), cracking, weeping, crusting, and scaling. Eczematous eruptions are the most common form of eruption. Furthermore, dry skin is a common complaint among atopic dermatitis patients.


Atopic dermatitis can affect anyone at any age, but it is more common in infants and young children. It may last until maturity on rare occasions or only appear at that age. Some patients have a long-term course with many ups and downs. Exacerbations or flares of the disease, in most cases, are followed by remissions, in which the skin improves or clears up completely. When children with atopic dermatitis reach adulthood, many of them experience a permanent remission of the condition, although their skin may remain dry and easily irritated.
Atopic dermatitis can be triggered or worsened by a variety of conditions, including low humidity, seasonal allergies, harsh soaps and detergents, and cold weather. Environmental factors can trigger atopic dermatitis symptoms at any point in a person's life who has inherited the atopic disease trait.

How common is atopic dermatitis?


Atopic dermatitis is very common worldwide and increasing in prevalence. It affects males and females equally and accounts for 10%-20% of all referrals to dermatologists (doctors who specialize in the care and treatment of skin diseases). Atopic dermatitis occurs most often in infants and children, and its onset decreases substantially with age. Of those affected, 65% of patients develop symptoms in the first year of life, and 90% develop symptoms before the age of 5. Onset after age 30 is uncommon and often occurs after exposure of the skin to harsh conditions. People who live in urban areas and climates with low humidity seem to be at an increased risk of developing atopic dermatitis.

Atopic dermatitis is not contagious, and it cannot be transmitted from one person to another via skin contact. Unless they have severe skin infections, being around someone with even an active case of atopic dermatitis is normally not a cause for concern. Secondary infections of the skin in atopic dermatitis patients include Staphylococcus, other bacteria, herpes virus (cold sores), and, less occasionally, yeasts and other fungal diseases. Skin contact may make some illnesses infectious.

What are the symptoms and signs of atopic dermatitis?

Although symptoms and indicators differ from person to person, dry, itchy, red skin is the most prevalent symptom; characterised by itching. The folds of the arms, the backs of the knees, the wrists, the face, and the neck are commonly afflicted skin areas. Scratching and rubbing can aggravate the skin inflammation that is characteristic of atopic dermatitis, therefore itching is a significant component. People with atopic dermatitis appear to be more sensitive to itching and scratch for longer periods as a result. They develop what is known as an "itch-scratch" cycle. When a person's skin is extremely itchy, he or she will scratch, which will aggravate the itch and so on.  Itching is particularly a problem during sleep when conscious control of scratching decreases and the absence of other outside stimuli makes the itchiness more noticeable.

Skin features of atopic dermatitis

Lichenification: thick, leathery skin resulting from constant scratching and rubbing Lichen simplex: refers to a thickened patch of raised skin that results from repeat rubbing and scratching of the same skin area

Papules: small, raised bumps that may open when scratched, becoming crusty and infected

Ichthyosis: dry, rectangular scales on the skin, commonly on the lower legs and shins.

Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs. These are also described as gooseflesh or chicken skin and may have a small coiled hair under each bump.

Hyper-linear palms: increased number of skin creases on the palms.

Urticaria: hives (red, raised bumps), often after exposure to an allergen, at the beginning of flare-ups, or after exercise or a hot bath

Cheilitis: inflammation of the skin on and around the lips.

Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye.

Dark circles under the eyes: may result from allergies and atopy

Hyperpigmented eyelids: scaling eyelids that have become darker in colour from inflammation or hay fever.

Prurigo nodules also called "picker's warts" are not warts at all. These are small thickened bumps of the skin caused by repeated picking of the same skin site.

Treatment

Atopic dermatitis can last a long time. To control it, you may need to try a variety of treatments over months or years. Even if treatment is successful, symptoms and signs may reappear (flare). It's critical to recognise the problem early on so that treatment can begin. If frequent moisturising and other self-care measures fail to relieve your symptoms, your doctor may recommend one or more of the following treatments:

  • Creams that control itching and help repair the skin. Your doctor may prescribe a corticosteroid cream or ointment. Apply it as directed, after you moisturize. Overuse of this drug may cause side effects, including thinning skin.
  • Drugs to fight infection. Your doctor may prescribe an antibiotic cream if your skin has a bacterial infection, an open sore or cracks. He or she may recommend taking oral antibiotics for a short time to treat an infection.
  • Oral drugs that control inflammation.


Therapies

  • Wet dressings. Effective, intensive treatment for severe atopic dermatitis involves wrapping the affected area with topical corticosteroids and wet bandages. Sometimes this is done in a hospital for people with widespread lesions because it's labour intensive and requires nursing expertise. Or, ask your doctor about learning how to do this technique at home.
  • Light therapy: This treatment is used for people who either don't get better with topical treatments or who rapidly flare again after treatment. The simplest form of light therapy (phototherapy) involves exposing the skin to controlled amounts of natural sunlight. Other forms use artificial ultraviolet A (UVA) and narrowband ultraviolet B (UVB) either alone or with medications.
  • Counseling: Talking with a therapist or other counsellor may help people who are embarrassed or frustrated by their skin condition.
  • Relaxation, behaviour modification and biofeedback: These approaches may help people who scratch habitually.


References

Retrieved from https://medtube.net/dermatology/medical-pictures/31182-atopic-dermatitis

Retrieved from https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279

Oheneba Kwakye Omane

Health Enthusiast and Futurist