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Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease that most commonly arises in childhood It is frequently associated with a personal or family history of allergic rhinitis or asthma. Up to 85% of AD patients have elevated serum immunoglobulin E (IgE) and positive immediate skin test. A subgroup of Atopic Dermatitis patients, however, is nonatopic with no apparent sensitization to food or inhalant allergens.

Atopic dermatitis is a chronic, itchy skin condition that is very common in children but may occur at any age. It is also known as eczema and atopic eczema . Atopic Dermatitis is the most common form of dermatitis . Atopic dermatitis (AD) is a pruritic disease of unknown origin that usually starts in early infancy and is typified by pruritus, eczematous lesions, xerosis (dry skin), and lichenification on the skin (thickening of the skin and increase in skin markings).Atopic dermatitis is not contagious! It arises because of a complex interaction of genetic and environmental factors. These include skin irritants, the weather, temperature and non-specific triggers: see Causes of atopic dermatitis .

Symptoms of Atopic Dermatitis

Acute AD lesions are characterized by intense pruritus, erythematous papules, and excoriations with a serous exudate, whereas chronic lesions consist of nonerythematous thickened plaques of skin with accentuated skin markings (lichenification). Fibrotic papules (prurigo nodularis) may be present in long-standing chronic Atopic Dermatitis lesions. Some symptons of Atopic Dermatitis :

  • The most common symptoms are dry, itchy skin; cracks behind the ears; and rashes on the cheeks, arms, and legs.
  • The way the skin is affected by atopic dermatitis can be changed by patterns of scratching and resulting skin infections.
  • Atopic dermatitis may also affect the skin around the eyes, the eyelids, and the eyebrows and lashes.

Evaluation of Severe Atopic Dermatitis

The grading of the severity of Atopic Dermatitis is based on the extent of affected areas, itch intensity, and appearance of the skin lesions. In general, patients with more than 20% skin involvement (or 10% skin involvement if affected areas include the eyelids, hands, or intertriginous areas) who have not responded to first-line treatment (see section on Management may be considered to have severe AD . Factors that contribute to severity of AD include the following:

  • Patients who are erythrodermic and at risk for exfoliation
  • Patients who require chronic high potency topical or systemic corticosteroids
  • Patients who require hospitalization for management of AD or skin infection due to Atopic Dermatitis
  • Patients with ocular complications such as keratoconus or keratoconjunctivitis
  • Patients with significant sleep, psychological, or developmental disturbances due to Atopic Dermatitis

Cause of Atopic Dermatitis

Main causes of Atopic Dermatitis:

  • Exact etiology is unknown, but several triggers have been identified. Anything that could dry the skin may exacerbate atopic dermatitis. Potential triggers include excessive bathing, swimming, hand washing, and lip licking.
  • Contact with solvents, detergents, deodorants, cosmetics, and soaps can exacerbate the disease. Cigarette smoke has also provoked inflammation.
  • Patients are extremely sensitive to temperature changes. They should avoid clothing that traps heat or causes sweating. They will also see increased flare-ups during times of low humidity, as dry air exacerbates the disease. Commercial humidifiers may help with the symptoms.

Treatment of Atopic Dermatitis

Commonly treatment methods of Atopic Dermatitis :

  • Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment
  • Antibiotics
  • Antihistamines
  • Phototherapy
  • Oral corticosteroids
  • Ciclosporin


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