Atopic dermatitis.
Atopic Dermatitis is a chronic eczematous skin disease that usually begins in childhood. Atopy is a special type of allergic hypersensitivity that is associated with asthma, inhalant allergies (hay fever), and a chronic dermatitis. There is a known hereditary component of the disease, and it is more common in affected families. In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, vesicle formation (minute blisters), cracking, weeping, crusting, and scaling. This type of eruption is termed eczematous. In addition, dry skin is a very common complaint in almost all those afflicted with atopic dermatitis. Most often it affects infants and young children. Multiple factors can trigger or worsen atopic dermatitis, including low humidity, seasonal allergies exposure to harsh soaps and detergents, and cold weather.
- Clinical features: Dry, itchy red skin affecting the folds of the arms, the back of the knees, wrists, face and neck. Scratching and rubbing can worsen the skin inflammation that is characteristic of this disease. Itching is particularly a problem during sleep, when conscious control of scratching decreases and the absence of other outside stimuli makes the itchiness more noticeable.
Atopic dermatitis seems to have a differing pattern of involvement depending on the age of a patient.
- Infantile phase - atopic dermatitis typically begins around 6 to 12 weeks. It starts on the face, lesions are erythema, confluent edematous papules. They are itchy and may become exudative and crusted. Secondary infection and lymphadenopathy are common.
- Childhood phase – face; popular, lichenified plaques, erosions, crusts.
- Adult phase – face and neck with lichenification (thick skin and leathery). Periorbital edema and darkening under the eyes.
- Diagnosis: Skin biopsy, Skin prick and scratch tests.
- Treatment: Cutaneous hydration; topical gluco-corticosteroids; treatment of infected lesions; avoid irritants.