Summary about Disease
Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory skin condition characterized by intensely itchy, dry, and inflamed skin. It's a common condition, especially in children, but can occur at any age. AD is often associated with other allergic conditions like asthma and hay fever, and it tends to flare up periodically. While there is no cure, various treatments can help manage symptoms and prevent flares.
Symptoms
Dry, itchy skin (pruritus) is the hallmark symptom.
Rash, often on the face, elbows, knees, wrists, and ankles, but can appear anywhere.
Thickened, leathery skin (lichenification) from chronic scratching.
Small, raised bumps that may leak fluid and crust over when scratched.
Raw, sensitive skin from scratching.
Skin discoloration (darker or lighter patches).
Scaly or crusty skin.
Sleep disturbance due to itching.
Causes
The exact cause of atopic dermatitis is unknown, but it's believed to be a combination of:
Genetics: A family history of AD, asthma, or hay fever increases the risk.
Immune system dysfunction: An overactive immune system triggers inflammation in the skin.
Skin barrier defects: A compromised skin barrier allows irritants and allergens to penetrate the skin, leading to inflammation and dryness.
Environmental triggers: Allergens (pollen, dust mites, pet dander), irritants (soaps, detergents, fragrances), stress, and temperature changes can trigger flares.
Medicine Used
Topical Corticosteroids: Reduce inflammation and itching. Vary in strength; use as directed by a doctor.
Topical Calcineurin Inhibitors (TCIs): Such as tacrolimus and pimecrolimus, reduce inflammation and are steroid-free.
Topical Phosphodiesterase-4 (PDE-4) Inhibitors: Crisaborole, another non-steroidal anti-inflammatory cream.
Moisturizers (Emollients): Help hydrate the skin and restore the skin barrier; use frequently.
Antihistamines: May help relieve itching, particularly at night.
Systemic Medications: For severe cases, may include oral corticosteroids, immunosuppressants (e.g., methotrexate, cyclosporine, azathioprine), or biologics (e.g., dupilumab).
Topical Antibiotics/Antivirals: If secondary skin infections develop.
Phototherapy (Light Therapy): Exposure to controlled amounts of ultraviolet light can help reduce inflammation.
Is Communicable
No, atopic dermatitis is not communicable. It is not contagious and cannot be spread from person to person through contact.
Precautions
Moisturize Regularly: Apply emollients (creams, lotions, ointments) liberally and frequently, especially after bathing.
Avoid Triggers: Identify and avoid substances or situations that worsen symptoms (e.g., harsh soaps, certain fabrics, allergens).
Bathe Briefly: Use lukewarm water and mild, fragrance-free cleansers. Pat skin dry instead of rubbing.
Avoid Scratching: Keep nails short and consider wearing gloves at night.
Manage Stress: Stress can trigger flares; practice relaxation techniques.
Use Humidifier: Especially in dry environments.
Wear Soft, Loose-Fitting Clothing: Avoid irritating fabrics like wool.
Follow Doctor's Instructions: Adhere to the prescribed treatment plan.
How long does an outbreak last?
The duration of an atopic dermatitis outbreak (flare) varies. It can last from a few days to several weeks or even months. With proper management, flares can be shortened and their severity reduced. Chronic AD is characterized by recurrent flares interspersed with periods of remission.
How is it diagnosed?
Diagnosis is typically based on:
Physical Examination: The doctor will examine the skin and ask about symptoms.
Medical History: Inquiry about personal and family history of atopic dermatitis, allergies, and asthma.
Allergy Testing: May be recommended to identify specific allergens that trigger flares (e.g., skin prick testing, blood tests).
Skin Biopsy: Rarely needed, but may be performed to rule out other skin conditions.
Timeline of Symptoms
The timeline of symptoms in atopic dermatitis varies greatly from person to person. Some individuals may experience:
Infancy: Often presents on the face and scalp.
Childhood: Common on the elbows, knees, wrists, and ankles.
Adulthood: Can be more widespread, affecting the hands, feet, and neck.
Acute Flare: Rapid onset of itching, redness, and rash.
Chronic Phase: Persistent dryness, thickened skin, and occasional flares. Symptoms may wax and wane over time.
Important Considerations
Individualized Treatment: Treatment plans should be tailored to the individual's specific needs and triggers.
Long-Term Management: Atopic dermatitis is often a chronic condition requiring ongoing management.
Secondary Infections: Scratching can lead to bacterial or viral infections, which require prompt treatment.
Psychological Impact: The constant itching and visible skin lesions can significantly impact quality of life and mental health. Support groups and counseling may be helpful.
Adherence to Treatment: Consistency in applying emollients and using prescribed medications is crucial for effective management.
Sun Protection: Protect skin from excessive sun exposure, as it can trigger flares in some individuals.