Atopic dermatitis (AD) or eczema is a very common long-lasting skin disease. Atopic dermatitis usually starts in infancy or early childhood and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years. It is a hereditary disease which runs in families with “atopic predispotition” that means families with history of eczema, asthma or hay fever. It is considered an immune-mediated, inflammatory disease which is triggered by “something” in the child’s environment.
Which are the trigger factors for Atopic Dermatitis/Eczema?
These are: using hot water for bathing, using soap, being in cold weather, and being in dry, hot temperatures, or being exposed in allergens like dust mites, eggs, pet dander etc.
What are the symptoms of atopic dermatitis?
• Severe itching
• Redness and swelling
• Very dry and scaly skin
• Small, raised bumps that may become crusty and leak fluid if scratched
• Open, crusted or weepy sores
• Thickened skin (lichenification).
• Darkened skin.
Symptoms come and go. Any area of the body may be affected. In babies, symptoms usually affect the face, neck, scalp, elbows, and knees but not the diaper area, where moisture protects the skin. In children, symptoms usually affect the skin inside the elbows, on the back of the knees, the sides of the neck, around the mouth, under the eyes and on the wrists, ankles and hands.
How is atopic dermatitis diagnosed in a child?
The diagnosis is easy made by a dermatologist. There are no specific tests for atopic dermatitis and are usually not necessary.
Which is the treatment of Atopic Dermatitis/Eczema?
Treatment depends on the child’s symptoms, age, general health and the severity of the disease. There is no cure for atopic dermatitis. The treatment aims to ease itching, and prevent infections.
That includes:
• Topical treatments with moisturizers, bathing practices, including additives, wet-wrap therapy with or without topical corticosteroids, corticosteroid creams or ointments, caclineurin inhibitor creams (tacrolimus, pimecrolimus ), Phototherapy (light therapy) with UVB.
• Systemic treatments with antihistamines, antibiotics, corticosteroids, immunomodulatory medication (in severe cases), and even biologic medicines (in very severe cases).
Are there possible complications due to Atopic Dermatitis/Eczema?
Atopic dermatitis can cause:
• thickened skin.
• bacterial skin infection.
• other allergy-related skin inflammation (allergic dermatitis).
• poor sleep because of intense itching.
• depression.
• thinning of the skin and tissue beneath it due to overuse of steroid creams.
Tips to prevent flare-ups of Atopic dermatitis/Eczema in children
• Avoid triggers. Common triggers are irritants such as wool, soap, chemicals, or allergens such as dust mites, pet dander or eggs. Even stress might also exacerbate the AD.
• Avoid scratching the skin. It can worsen the symptoms and cause infection.
• Always have short fingernails. Keep them short to prevent from scratching.
• Apply moisturizers on a daily basis.
• Have baths or showers with warm, not hot, water.
• Wear soft clothing. Avoid wool or other rough fabric.
• Keep cool.
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