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Atopic dermatitis  

Atopic dermatitis (AD- a type of eczema is an inflammatory, chronically relapsing, non-contagious and pruritic skin disorder. Other common names include rurigo Besnier, neurodermitis, endogenous eczema, flexural eczema, infantile eczema, and rurigo diathsique.

Characteristics

The skin of a patient with atopic dermatitis reacts abnormally to irritants, food, and environmental allergens and becomes red, flaky and very itchy. It also becomes vulnerable to surface infections caused by bacteria.The skin on the flexural surfaces of the joints (inner sides of elbows and knees) are the most commonly affected regions in most people.

 

Atopic dermatitis often appears together with other atopic diseases such as hay fever, asthma. It is a familial and chronic disease and its symptoms can increase or disappear over time. Atopic dermatitis afflicts humans, particularly young children and it is also a well-skin disorder in domestic dogs.

 

Although there is no cure for atopic eczema, and its cause is not well understood, it can be treated very effectively in the short term through a combination of prevention (learning what triggers the allergic reactions) and drug therapy.

 

Atopic dermatitis often begins in childhood before age 5 and may persist into adulthood. For some, it flares periodically and then subsides for a time, even up to several years. It is estimated that 75% of the cases with atopic dermatitis improve by the time children reach adolescence, and an estimated 25% continue to have difficulties with the condition through adulthood.

 

Theoretically Atopic dermatitis can affect any part of the body, but it tends to be more frequent on the hands and feet, the ankles, wrists, face, neck and upper chest. Atopic dermatitis can also affect the skin around the eyes, including the eyelids.

Some of the usual symptoms that occur with this type of dermatitis dry skin, stress, low humidity and sweating, dust, sand or cigarette smoke. Taking long and hot baths or showers, solvents, cleaners, detergents and even wool fabrics or clothing can worsen the condition.

 

Atopic dermatitis is also known as baby or infantile eczema, when it occurs in infants. This type eczema may continue into childhood and adolescence and it often involves an oozing, crusting rash mainly on the scalp and face, although it can occur anywhere on the body.

 

Symptoms

Approximately 50% of the patients who develop the condition display symptoms before the age of 1, and 80% display symptoms between the 5 years of life. Varying from person to person the symptoms are usually present as a red, inflamed, itchy rash that can quickly develop into painful bumps. The first sign is the red to brownish-gray colored patches that are usually very itchy and may  become more intense during the night. You might see some small and raised bumps which may be crusting or oozing if scratched, scratching will also worsen the itch. The skin tends to be more sensitive and may thicken, crack or scale.

 

When it appears in the area next to the eyes, scratching can cause redness and swelling, rubbing or scratching in this area causes patchy loss of eyebrow hair and eyelashes. The symptoms of atopic dermatitis vary with the age of the patients. Usually, in infants, the condition causes red, scaly, oozy and crusty cheeks and may also appear on their legs, neck and arms. The symptoms usually clear up in about half of these children by the time they are 2 or 3 years old.

 

In older children, the symptoms include dry, thick and scaly skin with a very persistent itch which is more severe than in infants. Adolescents are more likely to develop thick, leathery and dull-looking lesions on their face, neck, hands, feet, fingers or toes.

 

Allergy

Although it is an inherited disease, eczema is primarily aggravated by contact with or intake of allergens. It can also be influenced by other factors that affects the immune system such as stress or fatigue. Atopic eczema consists of chronic inflammation and often occurs in people with a history of allergic disorders such as asthma or hay fever. There is no certain cause of atopic dermatitis. In dogs, atopic dermatitis can be caused by or aggravated by inhaled allergens, food allergens, and flea bites; however, in human, such relationships are not well established.

 

Food allergy

Food allergy is often present in children wit atopic dermatitis, even though it is not the cause. New-onset atopic dermatitis patients at a later age or severe atopic dermatitis often warrant referral to an allergist for food allergy testing. Many dermatologists and physicians test for food allergy in their office. Common food allergen causing eczematous dermatitis include peanuts, tree nuts, shellfish, fish, milk, and egg.

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Prevention

Since there is no cure for atopic eczema, treatment should mainly involve discovering what  triggers are of allergic reactions and avoiding them.

 

Diet

The association of food allergy with atopic dermatitis has now been clearly demonstrated. Many common food allergens can trigger an allergic reaction: such as milk, nuts, cheese, tomatoes, wheat, yeast, soy, and corn. Many of these allergens are common ingredients in grocery store products such as corn syrup, which is a sugar substitute. The best way to avoid these problems is breastfeeding. But if this is not possible, then hydrolyzed formulas should be preferred over cow's milk. The consumption of organic dairy products by children and breastfeeding or pregnant mothers reduces the risk of atopic dermatitis in young children.

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