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What is atopic dermatitis?
Atopic dermatitis is one of the many types of eczema. Its prevalence rate in the United States is roughly 10 to 12% in children and 0.9% in adults. Unfortunately, evidences of increase in number are currently observed, substantiated by the reports of increased physician visits concerning atopic dermatitis in the United States. Atopic dermatitis is usually common but not limited to young children and infants alike. It is usually chronic in nature, meaning it could last up to months or years if proper intervention is not applied. Basically, “atopic” means hereditary or something that you could get from your parents or anyone in your family bloodline. “Dermatitis”, on the other hand, is the term used when the skin undergoes inflammation. Ergo, atopic dermatitis is an inflammation of the skin that is inherited from a person with the same genetic make-up as yours, such as your parents or grandparents. Moreover, as we delve deeper, atopic dermatitis is specifically a type I immediate hypersensitivity disorder.
Significant increase in serum IgE and peripheral eosinophilia is also seen in most people affected by the disease. In addition, the person affected will experience uneasiness and discomfort due to the condition’s signs and symptoms such as itchiness, pruritus or the intense sensation of itching, redness, swelling, scaling and cracking of the skin due to excessive dryness among others. This excessive dryness is associated with the changes in the activities of the sebaceous gland (the gland that produces sweat) and alterations of the lipid content.
Atopic dermatitis can have episodes of exacerbation wherein the signs and symptoms flare up. However, remissions will then follow wherein the signs and symptoms clear out and the skin seems to be devoid of any physical symptoms.
Severe atopic dermatitis
At this juncture, let us now discuss what transpires when atopic dermatitis worsens and severe atopic dermatitis takes place. Generally, this occurs when episodes of exacerbation arise. And what happens is that the present signs and symptoms all flare up and dramatically intensifies the discomfort brought about by the disease.
Atopic dermatitis symptoms
As what is previously stated, atopic dermatitis’ symptoms are caused by changes in the activities of the sebaceous gland and lipid content. These signs and symptoms are as follows: itchiness, pruritus or the intense sensation of itching, redness, swelling, scaling and cracking of the skin due to excessive dryness. In addition, pruritus and hyperirritability (the two most common and consistent symptoms of atopic dermatitis) are associated with excessive amounts of histamine in the skin.
Moreover, these symptoms can lead to lesions brought about by scratching in response to itchiness. When scratched, the skin initially gets red and then followed up by 15 to 30 seconds of pallor. If continually scratched, the lesion now comes into the picture. Lastly, complications like kaposi varicelliform eruption and anaphylactic reaction among others, can also occur if proper intervention is not employed.
Atopic dermatitis in children
As stated earlier, atopic dermatitis is mostly common but not limited to children. According to statistics, almost a 9/10 fraction of cases occur at the first year of life and more than a 9/10 fraction of cases appear before the child reaches the age of five. The development of thickened scales or lichenification is common in children because they scratch the affected area repeatedly and in an uncontrollable manner.
Generally, the child’s skin appears flaky and rough. Xerosis or dryness of the skin is usually observed all over the body. Specific manifestations such as eczematous and exudative lesions, face pallor, erythema and scaling of the eyes typically occur in children affected by atopic dermatitis.
Atopic dermatitis in infants
As young as a week to a few months old, infants are also commonly affected by atopic dermatitis. This condition is medically termed as infantile eczema. Commonly, the manifestations in the skin or the crusting rash appear in the scalp and the face. However, it can still occur in any parts of the infant’s body, particularly the cheeks, the forehead and the legs. Lichenification is however, seldom seen in infancy since infants still lack the ability to scratch on the itchy area of the skin.
Canine Atopic dermatitis
As we finish discussing atopic dermatitis in children and infants, we now delve into a new topic, which is canine atopic dermatitis or the atopic dermatitis affecting the dogs. Just like in the case of humans, the dogs generally acquire atopic dermatitis through inheritance or genetic predisposition. Along with environmental stimuli such as dust mites and pollens, the dog develops atopic dermatitis. Due to the hereditary nature of atopic dermatitis, these breeds are the ones commonly affected with the disease: golden retrievers, most terriers, Irish setters, Lhasa apsos, Dalmatians, bulldogs and Old English sheep dogs among others. Oftentimes, dog owners scold their dogs for uncontrollable and persistent scratching, rubbing and licking of a certain body part, which in turn produces redness, hair loss and thickening of the skin.
What the dog owners do not know is that this behavior of their pet is a hallmark symptom of canine atopic dermatitis. To verify if the dog really has atopic dermatitis, veterinarians often perform intradermal testing and/or in vitro (blood) testing as their diagnostic tool.
Atopic dermatitis Pictures
Atopic dermatitis mostly occur in the folds of the elbows, front of the neck or on the backs of the knees.
Here are some of the photos of the atopic dermatitis.
Picture 1 : Atopic dermatitis on chest
Image source : mayoclinic Inc
Picture 2 : Atopic dermatitis on legs
Image source : mayoclinic Inc
Picture 3 : Atopic dermatitis on forehand
Picture 4 : Atopic dermatitis
Treatment for Atopic dermatitis
So after the nitty-gritty of atopic dermatitis has been laid out, perhaps the next best thing to discuss is the treatment of atopic dermatitis. So how is atopic dermatitis being treated? More often than not, atopic dermatitis’ treatment regimen is individualized. Meaning, there is no generic treatment therapy being followed, rather the treatment therapy caters to the specific needs of an individual. Generally, the goal of treatment is to reduce as well as prevent the primary discomforting signs and symptoms of atomic dermatitis, which are itching and scratching. This can be done by following these simple rules:
- As much as possible, wear cotton fabrics to provide more comfort and prevent irritation,
- Wash your clothes using a mild detergent because strong detergents can be irritating to the skin,
- During the winter season, make sure to humidify the dry heat being produced by heaters,
- Maintain the room temperature within the range of 20 degrees celcius to 22.2 degrees celcius,
- Administration of antihistamines like diphenhydramine,
- Keeping away from potential environmental irritants such as dusts and sprays among others,
- Keeping your skin moisturized by using topical skin moisturizers, and lastly,
- Make it an unfaltering habit to take a bath daily to hydrate the skin.
However, if the above mentioned failed to alleviate or stop atomic dermatitis from materializing, then the next step is to administer pharmacologic therapies or in simple terms, the taking in of medications. Primarily, corticosteroids are administered to fight off inflammation; these corticosteroids are typically in topical form. Moreover, if the presence of bacteria is detected, the administration of antibiotics is subsequently done. Furthermore, the T cells and B cells involved in atopic dermatitis can be inhibited by using immunosuppresive agents such as cyclosporine, tacrolimus and pimecrolimus.
PAlthough the use of these medications might have shown therapeutic effects to the patient, a great deal of caution should still be used since the effectiveness and adverse side effects of these atopic dermatitis medications are not yet sturdily established.
References
http://www.medicinenet.com/atopic_dermatitis/article.htm
http://emedicine.medscape.com/article/1049085-overview
