Atopic Dermatitis Health Article

Definition

Eczema is a general term used to describe a variety of conditions that cause an itchy, inflamed skin rash. Atopic dermatitis, a form of eczema, is a non-contagious disorder characterized by chronically inflamed skin and sometimes intolerable itching.

Description

Atopic dermatitis refers to a wide range of diseases that are often associated with stress and allergic disorders that involve the respiratory system, like asthma and hay fever. Although atopic dermatitis can appear at any age, it is most common in children and young adults. Symptoms usually abate before the age of 25 and do not affect the patient's general health.

About one in ten babies develop a form of atopic dermatitis called infantile eczema. Characterized by skin that oozes and becomes encrusted, infantile eczema most often occurs on the face and scalp. The condition usually improves before the child's second birthday, and medical attention can keep symptoms in check until that time.

When atopic dermatitis develops after infancy, inflammation, blistering, oozing, and crusting are less pronounced. The patient's sores become dry, turn from red to brownish-gray, and skin may thicken and become scaly. In dark-skinned individuals, this condition can cause the complexion to lighten or darken. Itching associated with this condition is usually worst at night. It can be so intense that patients scratch until their sores bleed, sometimes causing scarring and infection.

Atopic dermatitis affects about 3% of the population of the United States, and about 80% of the people who have the condition have one or more relatives with the same condition or a similar one. Symptoms tend to be most severe in females. Atopic dermatitis can erupt on any part of the skin, and crusted, thickened patches on the fingers, palms, or the soles of the feet can last for years. In teenagers and young adults, atopic dermatitis often appears on one or more of the following areas:

• elbow creases
• backs of the knees

• ankles
• wrists
• face
• neck
• upper chest
• palms and between the fingers

Causes and symptoms

While allergic reactions often trigger atopic dermatitis, the condition is thought to be the result of an inherited over-active immune system or a genetic defect that causes the skin to lose abnormally large amounts of moisture. The condition can be aggravated by a cycle that develops in which the skin itches, the patient scratches, the condition worsens, the itching worsens, the patient scratches, etc. This cycle must be broken by relieving the itching to allow the skin time to heal. If the skin becomes

broken, there is also a risk of developing skin infections which, if not recognized and treated promptly, can become more serious.

Symptoms of atopic dermatitis include the following:

• an itchy rash and dry, thickened skin on areas of the body where moisture can be trapped
• continual scratching
• chronic fatigue, caused when itching disrupts sleep

An individual is more at-risk for developing the condition if there is a personal or family history of atopic dermatitis, hay fever, asthma, or other allergies. Exposure to any of the following can cause a flare-up:

• hot or cold temperatures
• wool and synthetic fabrics
• detergents, fabric softeners, and chemicals
• use of drugs that suppress immune-system activity

Certain foods, such as peanuts, cow's milk, eggs, and fish, can trigger symptoms of atopic dermatitis. A small percentage of patients with atopic dermatitis find that their symptoms worsen after having been exposed to dust, feather pillows, rough-textured fabrics, or other materials to which dust adheres.

Diagnosis

Diagnosis of atopic dermatitis is usually based on the patient's symptoms and personal and family health history. Skin tests do not generally provide reliable information about this condition.