sausa oda - March 22, 2023

Atopic dermatitis. Basic things the patient needs to know

Atopic dermatitis. The criteria by which a doctor can diagnose it is a typical rash on the skin. Atopic dermatitis is a common, often persistent skin disease that affects a large part of the world's population. Atopy is a special type of allergic hypersensitivity associated with asthma, inhalant allergies (hay fever) and chronic dermatitis. There is a known hereditary component to the disease, which occurs more often in affected families. The term atopic comes from the Greek word for "strange". The term dermatitis means inflammation of the skin. Many doctors and patients use the term eczema when referring to this condition. This is sometimes called neurodermatitis.
With atopic dermatitis , the skin is extremely itchy and inflamed, causing redness, swelling, blistering (small blisters), cracking, crusting and scaling. This type of dermatitis is called eczema. In addition, dry skin is a very common complaint of almost everyone with atopic dermatitis.
Although atopic dermatitis can occur at any age, it is most common in infants and young children. Sometimes it may persist into adulthood or may occur rarely. Some patients have a long-term presentation with ups and downs. In most cases, there are periods when the disease is more severe, called exacerbations, followed by periods when the skin improves or clears up completely, called remissions. Many children with atopic dermatitis go into permanent remission, but their skin may remain somewhat dry and easily irritated.
Atopic dermatitis can be caused or worsened by several factors, including low humidity, seasonal allergies, exposure to harsh soaps and detergents, and cold weather. Environmental factors can trigger the symptoms of atopic dermatitis at any point in life for people with an inherited predisposition to atopic disease.
Atopic dermatitis is very common throughout the world. It affects men and women equally and accounts for 10-20% of all referrals to dermatologists (doctors who specialize in the care and treatment of skin conditions). Atopic dermatitis usually affects babies and children, and its manifestations decrease with age. 65% of patients have symptoms in the first year of life, and 90% by the age of 5.
Atopic dermatitis can appear as early as 30 years of age, and it often occurs after the skin has been exposed to harsh conditions. People who live in cities and in climates with low humidity seem to have a higher risk of developing atopic dermatitis. About 10% of all babies and young children experience symptoms of the disease.
Approximately 60% of these infants continue to have one or more symptoms of atopic dermatitis well into adulthood.
What are the symptoms and signs of atopic dermatitis ?
Although symptoms and signs may vary from person to person, the most common symptoms are dry , itchy, red skin. Commonly affected skin areas include the creases of the hands, backs of the knees, wrists, face and neck. Itching is an important factor in atopic dermatitis, as scratching and rubbing can worsen the skin inflammation characteristic of this disease. People with atopic dermatitis seem to be more sensitive to itching and feel the need to scratch longer. They develop the so-called "itch-scratch" cycle. Severe itching of the skin causes a person to scratch, which in turn aggravates the itching and so on. Itching is particularly a problem during sleep, when conscious control of scratching is reduced and the absence of other external stimuli makes itching more noticeable.
Is atopic dermatitis contagious?
No. Atopic dermatitis itself is not really contagious and cannot be passed from one person to another through the skin. There is usually no reason to worry if someone with even active atopic dermatitis is around, unless they have active skin infections.
Some patients with atopic dermatitis develop secondary skin infections caused by staph, other bacteria, herpes virus (cold sores), and less commonly yeast and other fungal infections. These infections can be spread through skin-to-skin contact.
Common aeroallergens include dust mites, pollen, mold, and dander from animal hair or skin. These aeroallergens, especially house dust mites, can worsen atopic dermatitis symptoms in some people. Although some researchers believe that aeroallergens are an important factor in atopic dermatitis, others believe that they are insignificant.
There is no reliable test to determine whether a particular aeroallergen is an aggravating factor for any individual. If the doctor suspects that an aeroallergen is contributing to the patient's symptoms, the doctor may recommend ways to reduce exposure to the offending substances. For example, the presence of house dust mites can be limited by encasing mattresses and pillows with special dustproof covers, washing bedding frequently in hot water, and removing carpeting. However, it is not possible to completely free the environment from aeroallergens.
What are the causes and risk factors of atopic dermatitis?
The cause of atopic dermatitis is unknown, but it appears to be caused by a combination of genetic (inherited) and environmental factors. There seems to be an underlying hypersensitivity of the skin and an increased tendency to itch. Evidence suggests that this disease is linked to other so-called atopic disorders, such as hay fever (seasonal allergies) and asthma, which many people with atopic dermatitis also have. Some risk factors include:

Hay fever and asthma; many children with symptoms of atopic dermatitis develop hay fever or asthma.
Lack of protein, filaggrin; many patients have reduced levels of a protein called filaggrin in their skin, which is important in maintaining normal skin hydration.
Weak immune system; As a result, such patients are prone to fungal infections of the feet and staphylococcal skin infections, as well as herpes simplex infections of the lips (eczema herpeticum) over large areas of the skin.
Stress; although emotional factors and stress can sometimes worsen the condition, they are not the main cause of atopic dermatitis.

What irritates the skin in atopic dermatitis
Irritants are substances that directly damage the skin, and when used in high enough concentrations for a long enough time, cause inflammation of the skin. This is :

Soap, detergents (and even water can cause inflammation)
Some perfumes and cosmetics
Dust or sand
Cigarette smoke (can irritate the eyelids)
Wool or synthetic fiber
Substances such as chlorine, mineral oil or solvents
Dust mites
Animal fur or dander
Flowers and pollen

What food allergies cause atopic dermatitis?
Allergens are substances from foods, plants, or animals that cause an overreaction of the immune system and cause inflammation (in this case, the skin). The importance of food allergy in atopic dermatitis is controversial. Although not all scientists agree, most experts believe that breastfeeding for at least four months can have a protective effect on the child.
If a food allergy is suspected, it may be helpful to keep a careful diary of everything the patient eats, noting any reactions. Identifying a food allergen can be difficult and require the care of an allergist if the patient is also exposed to other allergens. One useful way to investigate the possibility of a food allergy is to remove the suspected food and, after improvement, reintroduce it into the diet under carefully controlled conditions. Usually, a two-week trial is sufficient for each food. If the tested food does not cause any symptoms after two weeks, another food can be tested later in the same way. Also, if elimination of foods does not improve after two weeks, other foods may be eliminated in turn.
Changing the diet of a person with atopic dermatitis may not always relieve symptoms. However, substitution may be beneficial when the patient's medical history and specific symptoms clearly indicate a food allergy. It is up to the patient and their family and physician to decide whether dietary restrictions outweigh the effects of the disease itself. It is often emotionally and financially difficult for patients and their families to follow restricted diets. Diets with many restrictions can also contribute to nutritional problems in children if not properly monitored.
What are the home remedies for atopic dermatitis?
Treatment involves a partnership between the doctor and the patient and family members. The doctor will suggest a treatment plan based on the patient's age, symptoms and general health. The patient and family members play an important role in a successful treatment plan by carefully following the doctor's instructions. Most patients can be successfully treated with proper skin care and lifestyle changes and do not need more intensive treatment.
Skin care . The main thing is simple and basic mode. It is very important to stick with one recommended soap and one moisturizer . Using multiple soaps, lotions, fragrances, and product mixes can cause additional problems and sensitize the skin.
Lifestyle changes . The healing and health of the skin is critical both to prevent further damage and to improve the patient's quality of life. Developing and following a daily skin care routine is critical to preventing recurring episodes of symptoms. The most important factor is proper bathing and applying emollient to wet skin without towel drying. An effective emollient is usually a fairly stiff ointment or cream. People with atopic dermatitis should avoid hot baths and showers. Your doctor may recommend that you limit the use of mild soap or a non-soap cleanser, as soap can dry out the skin. Oatmeal baths are often helpful. Red, irritated areas can be treated with 1% hydrocortisone cream (two to three times a day), which is available at most pharmacies and does not require a prescription.
Apply conditioner immediately after bathing without towel drying. It restores moisture to the skin and stops water evaporation, accelerates the healing rate and creates a barrier against further dryness and irritation. Lotions are generally not recommended because they contain a lot of water or alcohol and evaporate quickly. Creams and ointments treat the skin better. Tar preparations can be very helpful in treating very dry, lichenified areas. Whatever preparation is chosen, it should contain as few fragrances and chemicals as possible.
Another factor in skin protection and recovery is to take measures to prevent recurrent skin infections . Although it may not be possible to completely prevent infections, the consequences of infection can be minimized if they are identified and treated early. Patients and family members should learn to recognize the signs of skin infections, including tiny pustules (pus-filled bumps) on the hands and feet, the appearance of oozing areas, or crusty yellow blisters. If you develop symptoms of a skin infection, you should see a doctor as soon as possible to start treatment.
Treatment of atopic dermatitis in infants and children
Bathe in lukewarm water. Apply an emollient immediately after bathing. Keep your child's nails short. When choosing clothes, choose soft cotton fabrics. Consider using antihistamines to reduce scratching at night. Keep the child in a cool place; consider a humidifier. Learn to recognize skin infections and seek treatment immediately. Try to distract the child with activities so that he does not play.
What is the prognosis of atopic dermatitis?
Although the symptoms of atopic dermatitis can be very severe and uncomfortable, the condition can be successfully managed. People with atopic dermatitis and their families can lead healthy, normal lives.