atopic dermatitis (redirected from Dermatitis, atopic)

Atopic Dermatitis 

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

Atopic dermatitis can erupt on any part of the skin. In infants, it often appears on the face, scalp, and knees, while it develops on the elbows, neck, back of the knees, and ankles in adults.

(Illustration by Electronic Illustrators Group.)

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.

Key terms

Corticosteroid — A steroid hormone produced by the adrenal gland or as a synthetic compound that reduces inflammation, redness, rashes, and irritation.

Dermatitis — Inflammation of the skin.

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.

Treatment

Atopic dermatitis cannot be cured, but the severity and duration of symptoms can be controlled. A dermatologist should be consulted when symptoms first appear, and is likely to recommend warm baths to loosen encrusted skin, followed by applications of petroleum jelly or vegetable shortening to prevent the skin's natural moisture from escaping.

Externally applied (topical) steroids or preparations containing coal tar can relieve minor itching, but coal tar has an unpleasant odor, stains clothes, and may increase skin-cancer risk. Excessive use of steroid creams in young children can alter growth. Pregnant women should not use products that contain coal tar. Topical steroids can cause itching, burning, acne, permanent stretch marks, and thinning and spotting of the skin. Applying topical steroids to the area around the eyes can cause glaucoma.

Oral antihistamines, such as diphenhydramine (Benadryl), can relieve symptoms of allergy-related atopic dermatitis. More concentrated topical steroids are recommended for persistent symptoms. A mild tranquilizer may be prescribed to reduce stress and help the patient sleep, and antibiotics are used to treat secondary infections.

Cortisone ointments should be used sparingly, and strong preparations should never be applied to the face, groin, armpits, or rectal area. Regular medical monitoring is recommended for patients who use cortisone salves or lotions to control widespread symptoms. Oral cortisone may be prescribed if the patient does not respond to other treatments, but patients who take the medication for more than two weeks have a greater-than-average risk of developing severe symptoms when the treatment is discontinued.

Allergy shots rarely improve atopic dermatitis and sometimes aggravate the symptoms. Since food allergies may trigger atopic dermatitis, the doctor may suggest eliminating certain foods from the diet if other treatments prove ineffective.

If symptoms are extremely severe, ultraviolet light therapy may be prescribed, and a wet body wrap recommended to help the skin retain moisture. This technique, used most often with children, involves sleeping in a warm room while wearing wet pajamas under dry clothing, rain gear, or a nylon sweatsuit. The patient's face may be covered with wet gauze covered by elastic bandages, and his hands encased in wet socks covered by dry ones.

A physician should be notified if the condition is widespread or resists treatment, or the skin oozes, becomes encrusted, or smells, as this may indicate an infection.

Alternative treatment

Alternative therapies can sometimes bring relief or resolution of atopic dermatitis when conventional therapies are not helping. If the condition becomes increasingly widespread or infected, a physician should be consulted.

Helpful alternative treatments for atopic dermatitis may include:

• Taking regular brisk walks, followed by bathing in warm water sprinkled with essential oil of lavender (Lavandula officinalis); lavender oil acts as a nerve relaxant for the whole body including the skin
• Supplementing the diet daily with zinc, fish oils, vitamin A, vitamin E, and evening primrose oil (Oenothera biennis)-all good sources of nutrients for the skin
• Reducing or eliminating red meat from the diet
• Eliminating or rotating potentially allergic foods such as cow's milk, peanuts, wheat, eggs, and soy
• Implementing stress reduction techniques in daily life.

Herbal therapies also can be helpful in treating atopic dermatitis. Western herbal remedies used in the treatment of this condition include burdock (Arctium lappa) and Ruta (Ruta graveolens). Long-term herbal therapy requires monitoring and should be guided by an experienced practitioner.

Other alternative techniques that may be useful in the treatment of atopic dermatitis include:

• Acupressure (acupuncture without needles) to relieve tension that may trigger a flare
• Aromatherapy, using essential oils like lavender, thyme (Thymus vulgaris), jasmine (Jasminum officinale) and chamomile (Matricaria recutita) in hot water, to add a soothing fragrance to the air
• Shiatsu massage and reflexology, performed by licensed practitioners, to alleviate symptoms by restoring the body's natural balance
• Homeopathy, which may temporarily worsen symptoms before relieving them, and should be supervised by a trained alternative healthcare professional
• Hydrotherapy, which uses water, ice, liquid, and steam, to stimulate the immune system
• Juice therapy to purify the liver and relieve bowel congestion
• Yoga to induce a sense of serenity.

Prognosis

Atopic dermatitis is unpredictable. Although symptoms occur less often with age and sometimes disappear altogether, they can recur without warning. Atopic dermatitis lowers resistance to infection and increases the risk of developing cataracts. Sixty percent of patients with atopic dermatitis will experience flares and remissions throughout their lives.

Prevention

Research has shown that babies weaned from breast milk before they are four months old are almost three times more likely than other babies to develop recurrent eczema. Feeding eggs or fish to a baby less than one year old can activate symptoms, and babies should be shielded from such irritants as mites, molds, pet hair, and smoke.

Possible ways to prevent flare-ups include the following:

• eliminate activities that cause sweating
• lubricate the skin frequently
• avoid wool, perfumes, fabric softeners, soaps that dry the skin, and other irritants
• avoid sudden temperature changes

A doctor should be notified whenever any of the following occurs:

• fever or relentless itching develop during a flare
• an unexplained rash develops in someone who has a personal or family history of eczema or asthma
• inflammation does not decrease after seven days of treatment with an over-the-counter preparation containing coal tar or steroids
• a yellow, tan, or brown crust or pus-filled blisters appear on top of an existing rash
• a person with active atopic dermatitis comes into contact with someone who has cold sores, genital herpes, or another viral skin disease

Resources

Organizations

American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumburg, IL 60168-4014. (847) 330-0230. Fax: (847) 330-0050. http://www.aad.org.

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dermatitis /der·ma·ti·tis/ (der″mah-ti´tis) pl. dermati´tides   inflammation of the skin.

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actinic dermatitis  dermatitis due to exposure to actinic radiation, such as that from the sun, ultraviolet waves, or x- or gamma radiation.

allergic dermatitis 

1. atopic d.

2. allergic contact d.

allergic contact dermatitis  contact dermatitis due to allergic sensitization.

ammonia dermatitis  diaper dermatitis attributed to skin irritation, due to the ammonia decomposition products of urine.

atopic dermatitis  a chronic inflammatory, pruritic, eczematous skin disorder in individuals with a hereditary predisposition to cutaneous pruritus; often accompanied by allergic rhinitis, hay fever, and asthma.

berlock dermatitis , berloque dermatitis dermatitis of the neck, face, or chest, with patches or streaks, caused by exposure to perfume or other toilet articles containing bergamot oil and then to sunlight.

cercarial dermatitis  swimmers' itch.

contact dermatitis  acute or chronic dermatitis caused by substances contacting the skin; it may involve allergic or nonallergic mechanisms.

diaper dermatitis  diaper rash.

dermatitis exfoliati´va neonato´rum  staphylococcal scalded skin syndrome.

exfoliative dermatitis  virtually universal erythema, desquamation, scaling, and itching of the skin, with loss of hair.

dermatitis herpetifor´mis  pruritic chronic dermatitis with successive groups of symmetrical, erythematous, papular, vesicular, eczematous, or bullous lesions, usually associated with asymptomatic gluten-sensitive enteropathy.

infectious eczematous dermatitis  a pustular eczematoid eruption arising from a primary lesion that is the source of an infectious exudate.

insect dermatitis  a transient skin eruption caused by the toxin-containing irritant hairs of insects such as certain moths and their caterpillars.

irritant dermatitis  a nonallergic type of contact dermatitis due to exposure to a substance that damages the skin.

livedoid dermatitis  local pain, swelling, livedoid changes, and increased temperature; due to temporary or prolonged local ischemia from vasculitis or from accidental arterial obliteration during intragluteal administration of medications.

meadow dermatitis , meadow-grass dermatitis phytophotodermatitis with eruption of vesicles and bullae in streaks or other configurations, caused by exposure to sunlight after contact with meadow grass.

photoallergic contact dermatitis , photocontact dermatitis allergic contact dermatitis caused by the action of sunlight on skin sensitized by contact with substances such as halogenated salicylanilides, sandalwood oil, or hexachlorophene.

phototoxic dermatitis  erythema followed by hyperpigmentation of sun-exposed areas of the skin, due to exposure to agents containing photosensitizing substances, such as coal tar and psoralen-containing perfumes, drugs, or plants, and then to sunlight.

poison ivy dermatitis , poison oak dermatitis, poison sumac dermatitis allergic contact dermatitis due to exposure to plants of the genus Rhus, which contain urushiol, a skin-sensitizing agent.

radiation dermatitis  radiodermatitis.

rat mite dermatitis  that due to a bite of the rat-mite, Ornithonyssus bacoti.

dermatitis re´pens  acrodermatitis continua.

rhus dermatitis  poison ivy, poison oak, or poison sumac d.

schistosome dermatitis  swimmer's itch.

seborrheic dermatitis , dermatitis seborrhe´ica chronic pruritic dermatitis with erythema, scaling, and yellow crust on areas such as the scalp, with exfoliation of excessive dandruff.

stasis dermatitis  chronic eczematous dermatitis due to venous insufficiency, initially on the inner aspect of the lower leg above the internal malleolus, sometimes spreading over the lower leg, marked by edema, pigmentation, and often ulceration.

swimmers' dermatitis  see under itch.

uncinarial dermatitis  ground itch.

x-ray dermatitis  radiodermatitis.

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atopic dermatitis

n.

Dermatitis characterized by intense itching, occurring in individuals predisposed to developing certain hypersensitivity reactions.

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atopic dermatitis,

an intensely pruritic, often excoriated inflammation commonly found on the face and antecubital and popliteal areas of allergy-prone (atopic) individuals. In infancy and early childhood it is called infantile eczema. Also called atopic eczema. Compare contact dermatitis. See also atopic.

observations There are no specific cutaneous signs of atopic dermatitis. The lesions seen are a result of scratching from intense itching. The constant and severe itching sets up an itch-scratch-rash-itch cycle that produces red, scaly papules, which coalesce into plaques that ooze and crust. Common sites include the hands, face, upper trunk, and flexural areas, such as bends in knees and elbows. Lesions tend to be symmetric on extremities. Evidence of recurrent conjunctivitis, herpes simplex infections, nipple dermatitis, eczema, ichthyosis, cheilitis, facial pallor or erythema, and wool or food intolerances may also be present. Diagnosis is made primarily through clinical evaluation and evidence of personal or family history. Immunofluorescence may show that elevated IgE levels and serum eosinophilia is present as cases worsen. Secondary infection is the most common complication. Chronic dermatitis, which appears on the hands or feet, can restrict function and become crippling.

interventions Primary treatment for acute outbreaks includes emollient lotions to decrease dry skin; topical steroids or pimecrolimus cream (Elidel) or tacrolimus ointment to decrease inflammation; oral antihistamines or other antipruritics to control itching. Outbreak prevention is aimed at avoiding triggering factors, such as sudden temperature shifts, contact with irritants, foods that provoke exacerbations, stressful situations, allergens, or excessive hand washing.

nursing considerations Nursing care is aimed at helping the individual break the itch-scratch cycle and reduce outbreaks. This includes proper use of topical medications, and instruction in ways to prevent or reduce outbreaks. Adequate rest can reduce the threshold for itching. Modest exercise in a controlled temperature environment can increase circulation. A balanced diet that avoids food triggers can strengthen skin protective functions. Hygiene is aimed at cleanliness, avoidance of drying, and maintenance of acidic pH on skin. Nails should be kept clipped to decrease abrasion from scratching. Affected individuals need to know that this is a genetically determined chronic disease with cycles of exacerbation and remission.

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atopic dermatitis (ā·tˑ·pik derˈ·m·tīˑ·tis),

n a common chronic skin condition that is a variant of the skin disease eczema and is char-acterized by thick, leathery skin, and dry rectangular-shaped scales. Hives, lesions, and small bumps with a rough texture may also indicate the condition. Often runs in families.

Atopic dermatitis.

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dermatitis (durmtī´tis),

n an inflammation of the skin.

dermatitis, allergic contact,

n the reaction of the skin to direct contact with a specific antigen. Poison ivy rash is a common example of an allergic contact dermatitis.

dermatitis, atopic

(ātō´pik),
n an atopic eczema characterized by the distinctive phenomenon of atopy, a familial related allergic response associated with IgE antibody.

dermatitis, contact,

n a delayed type of induced sensitivity (allergy) of the skin with varying degrees of erythema, edema, and vesiculation, resulting from cutaneous contact with a specific allergen. It is an occupational hazard in dentistry.

dermatitis herpetiformis

n dermatitis characterized by grouped, erythematous, papular, vesicular, pustular, or bullous lesions occurring in various combinations, often accompanied by vesicobullous and ulcerative lesions of the oral mucosa.

dermatitis infectiosa eczematoides (Engman's disease),

n a pustular eczematous eruption that frequently follows or occurs coincidentally with some pyogenic process.

dermatitis, occupational,

n a contact dermatitis associated with allergens found in the workplace.

dermatitis, radiation,

n an inflammation of the skin resulting from a high dose of radiation. The reaction varies with the quality and quantity of radiation used and is usually transitory.

dermatitis, seborrheic

n a chronic inflammatory skin disease that can affect the scalp, face, ears, armpits, breasts, and groin. Its symptoms include moist, greasy, or dry scaling and patches of yellowish crust. Although the cause is unknown, it can be treated with selenium sulfide shampoos, topical antibiotics, and topical and oral corticosteroids.

Dermatitis.

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atopic

1. displaced; ectopic.

2. pertaining to atopy.

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atopic asthma

see allergic asthma.

atopic dermatitis

called also atopic disease, allergic inhalant dermatitis. See canine atopy.

atopic disease

see atopic dermatitis (above).

atopic rhinitis

see enzootic nasal granuloma, atopy.

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dermatitis

inflammation of the skin. Dermatitis can result from various animal, vegetable and chemical substances, from heat or cold, from mechanical irritation, from certain forms of malnutrition, or from infectious disease.

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actinobacillary dermatitis

rare disease in cattle; large ulcers discharging yellow pus or nodules, on lymphatics with local lymph node enlargement.

acute moist dermatitis

a superficial bacterial infection of the skin, usually caused by self-trauma, i.e. scratching, rubbing, biting. In dogs, ectoparasites, otitis, anal sacculitis and pruritic skin diseases are common precipitating causes. Affected skin is moist, weeping, and has a covering of matted haircoat and dried exudate. Staphylococcus spp. are usually present. Called also pyotraumatic dermatitis, 'hot spots'.

allergic contact dermatitis

see allergic contact dermatitis.

allergic inhalant dermatitis

see canine atopy.

atopic dermatitis

see canine atopy.

cercarial dermatitis

see trichobilharzia.

cheyletiella dermatitis

see cheyletiella.

contagious pustular dermatitis of sheep

see contagious ecthyma.

coronet dermatitis

part of several infectious mucosal diseases of cattle; also in equine pemphigus.

dermatitis crustosa

exudative epidermitis.

elaeophorial dermatitis

see elaeophoriasis.

equine contagious pustular dermatitis

see canadian horsepox.

equine exfoliative eosinophilic dermatitis

characterized by infiltration of eosinophils and granulomatous inflammation with ulcerative stomatitis and wasting; suspected of being a hypersensitivity to Strongylus equinus larvae.

equine staphylococcal dermatitis

see equine staphylococcal dermatitis.

exudative dermatitis of pigs

see exudative epidermitis.

feline miliary dermatitis

a papular, crusting skin disease located predominantly on the back, with varying degrees of pruritus. Ectoparasites, food and drug allergy, and infection by fungi or bacteria are among the many possible causes. Called also scabby cat disease.

feline psychogenic dermatitis

see idopathic hyperesthesia syndrome.

feline solar dermatitis

see solar dermatitis (below).

fibrosing dermatitis

dermatitis sufficiently severe to affect deep layers of the dermis results in scarring of the skin due to excessive fibrous tissue formation.

filarial dermatitis

see stephanofilarosis, onchocercosis.

fold dermatitis

moisture, friction and secondary infection in body folds such as facial fold in brachycephalic dog breeds, tail fold in dog breeds with extremely short, often screw, tails, lip fold in spaniel breeds, perivulvar fold in obese bitches, and all over the body in the Shar pei.

Nasal fold dermatitis in a Bulldog. By permissionfrom Kummel BA, Color Atlas of Small Animal Dermatology,Mosby, 1989

grain itch mite dermatitis

a transient, superficial dermatitis, mostly about the head in horses; may be all over the body in pigs. Caused by pediculoides ventricosus or tyroglyphus.

granular dermatitis

swamp cancer.

dermatitis herpetiformis

chronic dermatitis in humans marked by successive crops of grouped, symmetrical, erythematous, papular, vesicular, eczematous or bullous lesions, accompanied by itching and burning; a granular deposition of IgA immunoglobulin around the lesion almost always occurs. Occurs rarely in dogs.

idiopathic caprine dermatitis

alopecic, exudative dermatitis of pygmy goats.

infectious dermatitis of piglets

see contagious porcine pyoderma.

inhalant dermatitis

see canine atopy.

interdigital dermatitis

see interdigital dermatitis.

interface dermatitis

a histopathological pattern of inflammatory skin disease with the dermoepidermal junction obscured by hydropic degeneration and/or lichenoid cellular infiltrate.

intertriginous dermatitis

see fold dermatitis (above).

intraepidermal pustular dermatitis

see equine allergic dermatitis.

lipfold dermatitis

see fold dermatitis (above).

Malassezia dermatitis

a pruritic, seborrheic skin disease of dogs, particularly some breeds including West Highland white terriers, Shetland sheepdogs, Poodles, and Cocker spaniels, and rarely cats, caused by colonization of the skin by the yeast, Malassezia pachydermatis. There is usually an underlying cause such as atopy or bacterial pyoderma.

mammary pustular dermatitis

see mammary pustular dermatitis.

dermatitis medicamentosa

an eruption or solitary skin lesion caused by a drug taken internally.

miliary dermatitis

see feline miliary dermatitis (above).

moist dermatitis of rabbits

the rabbit's pendulous dewlap keeps getting wet and develops a moist dermatitis as a result. Called also slobbers, wet dewlap.

mycotic dermatitis

see mycotic dermatitis.

nasal solar dermatitis

see solar dermatitis (below), collie nose.

ovine interdigital dermatitis

see ovine footrot.

ovine staphylococcal dermatitis

ulcerative dermatitis of the face of adult sheep and young lambs caused by a dermatopathic strain of Staphylococcus aureus. Called also ovine staphylococcal pyoderma.

pastern dermatitis

see greasy heel.

pelodera dermatitis

caused by larvae of the free-living nematode Pelodera strongyloides and characterized by alopecia, itching, thick, scurfy skin and 0.5 inch diameter pustules which contain the larvae.

photocontact dermatitis

allergic contact dermatitis caused by the action of sunlight on skin sensitized by contact with a substance capable of causing this reaction.

photosensitive dermatitis

see photosensitive dermatitis.

plastic dish dermatitis

a contact dermatitis caused by plastic feeding dishes to which a dog is allergic.

porcine juvenile pustular psoriasiform dermatitis

see pityriasis rosea.

potato dermatitis

see potato dermatitis.

primary-irritant dermatitis

contact dermatitis (see above) induced by a substance acting as an irritant rather than as a sensitizer or allergen.

proliferative dermatitis

see strawberry footrot.

psoriaform, psoriasiform dermatitis of swine

see pityriasis rosea.

pyotraumatic dermatitis

see acute moist dermatitis (above).

dermatitis-pyrexia-hemorrhage syndrome

a pruritic, papulocrustous dermatitis in dairy cows which is accompanied by fever and hemorrage from the nose and anus. It is believed to be caused by a toxin.

rhabditic dermatitis

see pelodera dermatitis (above).

seasonal allergic dermatitis

see atopy, equine allergic dermatitis.

seborrheic dermatitis, dermatitis seborrheica

a chronic, usually pruritic, dermatitis with erythema, dry, moist or greasy scaling, and yellow crusted patches on various areas, with exfoliation of an excessive amount of dry scales (dandruff) or encrustations of sebum on the skin. See also exudative epidermitis (pigs), greasy heel (horses), flexural seborrhea (cows).

solar dermatitis

a chronic, inflammatory reaction on white or lightly pigmented and exposed skin caused by sunlight. Most commonly seen on the ear tips, nose and eyelids of white cats and the nose of collie dogs or related breeds. Squamous cell carcinomas sometimes develop in affected skin. Called also nasal solar dermatitis, actinic dermatitis. See also collie nose.

spongiotic dermatitis

perivascular inflammation with spongiosis.

summer dermatitis

see equine allergic dermatitis.

superficial pustular dermatitis

immature dogs may develop pustules on the inguinal or axillary skin, often in association with poor nutrition, systemic infection, or parasitism. In kittens, these may occur on the neck, caused by 'mouthing' by the queen.

trefoil dermatitis

see trefoil dermatitis.

tyroglyphid dermatitis

see tyroglyphus.

unilateral papular dermatitis

a disease of horses characterized by the appearance of many nodules or papules on one side of the neck and body. The lesions are eosinophilic folliculitis and perifolliculitis. The etiology and the unilateral distribution of the lesions are unexplained.

ventral midline dermatitis

small ulcers with hemorrhagic crusts and hair loss, located on the abdomen, particularly around the umbilicus, of horses; caused by biting flies and gnats.

vesicular dermatitis

see avian vesicular dermatitis.

viral contagious dermatitis

see contagious ecthyma.

viral papular dermatitis

see equine papular dermatitis.

x-ray dermatitis

radiodermatitis.

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atopic dermatitis

Atopic eczema, infantile eczema, neurodermatitis Immunology An immune-mediated dermatopathy affecting 1-3% of children, which is characterized by severe pruritus of early–usually in infancy onset, and a familial tendency; it may be associated with IgE-mediated skin reactions, allergic rhinitis and/or asthma Etiology Idiopathic in children; in adults, hypersensitivity to chemicals–eg detergents or soaps, metals–eg nickel or plants–eg poison ivy, poison oak Clinical In infancy, AD tends to be a weeping, papulovesicular—which rupture and ooze, and intensely pruritic inflammation of cheeks and inguinal region; in later childhood, it is more lichenified and is more prevalent over antecubital, popliteal, and collar regions Exacerbating factors Anxiety, stress, depression Lab Eosinophilia Management Avoid known allergens; reduce skin dryness scratching, and inflammation; antihistamines Side effect Burning sensation; the ↑ susceptibility of Pts with AD to infection may be due to a ↓ in expression of antimicrobial peptides See Endogenous antimicrobial peptide, Tacrolimus.

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Patient discussion about atopic dermatitis.

Q. I have atopic dermatitis and its been out of control : ( i was wondering any suggestions what to do? This past year i have experienced 2 bacterial infections due to my open soars as well as a viral infection in which i was hospitalized. im so fusterated and scared i dont know what to do.. i personally dont think that creams and ointments work all that well. From what i have gathered eczema comes from the inside out? :S i also have allergies i tend to be allergic to everything environmental, animals dust, mold, as well as oral allergy syndrom to alot of foods. which is very difficult. i have been to numerous doctors and specialsist and they dont know what to do. the next step is to put me on an oral medication, sure it prevents it from coming but there are also alot of disadvantages to taking the pill. They also wanted me to go for uvb lights which are knowen to treat psriosis, which personalyy i dont feel it helps me ..realie.. eczema and psriosis are 2 totally diff skin diseases.. someone . PLEASEE HELP .. : )

A. this actualy works.. one tsp. of apple cider vinegar per day diluted in alot of water or apple juice. my son who is 3 yrs. old had horrible sores from ecsima and it was cleared up within 2 wks. he had been struggling with the condition his whole life and now he has been clear for 6mos. topically applied it burns like hell so dont apply it topically untill after the first week of treatment with dilution of water taken internally. by then the sores and itching should be gone..
don't do steroide cream unless necessary, the side affects greatly out weigh the potential good. i sincerely hope this helps you. let me know..

Q. My son has atopic dermatitis that is treated with topical cream. Is he in a greater risk for other diseases? My 1 year old son has atopic dermatitis. We treat him with topical cream and he is getting better. What kind of a diseases is this? Is he in a greater risk for other diseases because of his skin lesions?

A. Your son has an increased risk for other diseases. this is not because of his skin lesions but because of the base pathology of his diseases. Atopic dermatitis is an immunological disease and someone that has it is in a greater risk to have other immunological diseases. It is not connected to how much you care for him or how much you keep him clean.
My little brother had atopic dermatitis when he was 9 months old and now he is 12 years old and he is healthy