Atopic dermatitis

Overview of Atopic Dermatitis

Atopic dermatitis, often referred to as eczema, is a chronic (long-term) condition that causes inflammation, redness, and irritation of the skin. This is a common condition that usually begins in childhood; however, anyone can get sick at any age. Atopic dermatitis is not contagious, so it cannot be passed from person to person.

Atopic dermatitis causes severe itching of the skin. Scratching leads to further redness, swelling, cracking, weeping clear liquid, crusting and peeling. In most cases, there are periods of aggravation of the disease, called flare-ups, followed by periods when the skin condition improves or clears up completely, called remissions.

Researchers don't know what causes atopic dermatitis, but they do know that genes, the immune system, and the environment play a role in the disease. Depending on the severity and location of symptoms, life with atopic dermatitis can be difficult. Treatment can help control symptoms. For many people, atopic dermatitis resolves by adulthood, but for some, it can be a lifelong condition.

Who gets atopic dermatitis?

Atopic dermatitis is a common condition and usually presents in infancy and childhood. In many children, atopic dermatitis resolves before adolescence. However, in some children who develop atopic dermatitis, symptoms may persist into adolescence and adulthood. Sometimes, in some people, the disease first appears in adulthood.

You are more likely to develop atopic dermatitis if you have a family history of atopic dermatitis, hay fever, or asthma. In addition, studies show that atopic dermatitis is more common in non-Hispanic black children and that women and girls develop the disease slightly more often than men and boys. 

Symptoms of atopic dermatitis

The most common symptom of atopic dermatitis is itching, which can be severe. Other common symptoms include:

• Red, dry patches of skin.
• A rash that may ooze, discharge a clear liquid, or bleed when scratched.
• Thickening and thickening of the skin.

Symptoms can appear in multiple areas of the body at the same time and may appear in the same places and in new places. The appearance and location of the rash varies with age; however, the rash can appear anywhere on the body. Patients with darker skin tones often have darkening or lightening of the skin in areas of skin inflammation.

Infants

In infancy and up to 2 years of age, a red rash that can be shed on scratching most often appears on:

• Face.
• Scalp.
• The area of ​​skin around the joints that touches when the joint is flexed.

Some parents worry that the baby has atopic dermatitis in the diaper area; however, this condition rarely appears in this area.

Detstvo

In childhood, usually between the ages of 2 years and puberty, the most common red, thickened rash that may ooze or bleed when scratched appears on:

• Elbows and knees are usually bent.
• Neck.
• Ankles.

Teenagers and adults

In adolescence and adulthood, the most common red to dark brown scaly rash that may bleed and crust when scratched appears on:

• Arms.
• Neck.
• Elbows and knees are usually bent.
• Skin around the eyes.
• Ankles and feet.

Other common skin manifestations of atopic dermatitis include:

• An extra fold of skin under the eye, known as a Denny-Morgan fold.
• Darkening of the skin under the eyes.
• Additional folds of skin on the palms of the hands and soles of the feet.

In addition, people with atopic dermatitis often have other conditions, such as:

• Asthma and allergies, including food allergies.
• Other skin conditions such as ichthyosis, in which the skin becomes dry and thick.
• Depression or anxiety.
• Sleep loss.

Researchers continue to study why atopic dermatitis in childhood can lead to asthma and hay fever later in life.

 Possible complications of atopic dermatitis. They include:

• Bacterial skin infections that can get worse with scratching. They are common and can make it difficult to control the disease.
• Viral skin infections such as warts or herpes.
• Loss of sleep, which can lead to behavior problems in children.
• Hand eczema (hand dermatitis).
• Eye problems such as:
  • Conjunctivitis (pink eye), which causes swelling and redness of the inside of the eyelid and the white part of the eye.
  • Blepharitis, which causes general inflammation and redness of the eyelid.

Causes of atopic dermatitis

Nobody knows what causes atopic dermatitis; however, researchers know that changes in the protective layer of the skin can lead to moisture loss. This can cause the skin to become dry, leading to skin damage and inflammation. New research shows that inflammation directly causes the sensation of itching, which in turn causes the patient to itch. This leads to further damage to the skin, as well as an increased risk of bacterial infection.

Researchers know that the following factors may contribute to changes in the skin barrier that helps control moisture:

• Changes (mutations) in genes.
• Problems with the immune system.
• Exposure to certain things in the environment.

Genetics

The likelihood of developing atopic dermatitis is higher if there is a family history of the disease, which suggests that genetics may play a role in the cause. Recently, researchers have discovered changes in the genes that control a certain protein and help our bodies maintain a healthy layer of skin. Without normal levels of this protein, the skin barrier changes, allowing moisture to evaporate and exposing the skin's immune system to the environment, leading to atopic dermatitis.

Researchers continue to study genes to better understand how various mutations cause atopic dermatitis.

The immune system

The immune system usually helps fight disease, bacteria, and viruses in the body. Sometimes the immune system becomes confused and overactive, which can cause skin inflammation leading to atopic dermatitis. 

Environment

Environmental factors can cause the immune system to change the skin's protective barrier, allowing more moisture to escape, which can lead to atopic dermatitis. These factors may include:

• Exposure to tobacco smoke.
• Some types of air pollutants.
• Perfumes and other compounds found in skin products and soaps.
• Excessively dry skin.