Dermatitis

Atopic dermatitis (eczema) is a medical condition that causes dry, itchy and inflamed skin. It is relatively common in young children but can occur at any stage of life. Atopic dermatitis is a chronic and tends to flare sometimes. It can be irritating but it is not contagious.

People with atopic dermatitis are at risk of developing food allergies, hay fever and asthma. Moisturizing regularly and following other skin care habits can relieve the symptoms such as itching and prevent new outbreaks. Treatment may also include medicated ointments or creams.

Sign and Symptoms

• Itchy dry skin
• Rashes on dry skin
• Oozing and crusting
• Dark circles
• Small or large raised bumps

Atopic dermatitis begins from the age of 5 and continue to teenage and adult. In some condition It continues to flare till adult age.

Some individuals experience atopic dermatitis due to a genetic variation that affects the skin's protective capabilities. This genetic predisposition results in a weakened barrier function, making the skin less effective at retaining moisture and shielding against bacteria, irritants, allergens, and environmental elements like tobacco smoke.

Risk Factors

Alternatively, in other cases, atopic dermatitis can be attributed to an overabundance of Staphylococcus aureus bacteria on the skin. This bacterial overgrowth displaces beneficial bacteria and disrupts the skin's barrier function.

The weakened barrier function can also trigger an immune system response, leading to inflammation of the skin and other associated symptoms.

It is worth noting that atopic dermatitis, commonly known as eczema, is just one type of dermatitis. Other prevalent types include contact dermatitis and seborrheic dermatitis, often associated with dandruff. Importantly, dermatitis is not contagious.

Is Dermatitis or Eczema an autoimmune disorder?

Dermatitis or Eczema does primarily affect immune system. However, it is not categorized as an autoimmune disorder.

Complications associated with atopic dermatitis (eczema) may include:

• Asthma and hay fever: Many individuals with atopic dermatitis develop asthma and hay fever, either before or after experiencing atopic dermatitis.
• Food allergies: Atopic dermatitis sufferers often develop food allergies, with hives (urticaria) being a common symptom.
• Chronic itchy, scaly skin: Neurodermatitis (lichen simplex chronicus) typically begins as a patch of itchy skin. Continuous scratching may lead to temporary relief but ultimately exacerbates the itchiness, causing the affected skin to become discolored, thick, and leathery over time.
• Patches of skin discoloration: Post-inflammatory hyperpigmentation or hypopigmentation can occur after the rash heals, particularly in individuals with brown or Black skin. The discoloration may take several months to fade.
• Skin infections: Repeated scratching can result in open sores and cracks, increasing the risk of bacterial and viral infections. If left untreated, these infections can spread and become life-threatening.
• Irritant hand dermatitis: Common among individuals whose hands are frequently wet and exposed to harsh soaps, detergents, and disinfectants, especially in occupational settings.
• Allergic contact dermatitis: People with atopic dermatitis are prone to developing allergic contact dermatitis, characterized by an itchy rash upon contact with allergenic substances. The rash's appearance varies depending on skin color.
• Sleep disturbances: The persistent itchiness associated with atopic dermatitis often disrupts sleep patterns.
• Mental health conditions: Depression and anxiety are commonly associated with atopic dermatitis, likely due to the chronic itching and sleep disturbances experienced by affected individuals.

Prevention

• Moisturize regularly: Apply moisturizer to your skin at least twice a day. Opt for creams, ointments, shea butter, or lotions to lock in moisture. Choose products that suit your skin type and preferences, ensuring they are safe, effective, affordable, and unscented.
• Consider petroleum jelly for babies: Using petroleum jelly on your baby's skin may help prevent the onset of atopic dermatitis.
• Take brief baths or showers: Incorporate a daily bath or shower into your routine, using warm water instead of hot water, and limiting the duration to approximately 10 minutes.
• Use a gentle cleanser: Select a non-soap cleanser that is free from dyes, alcohols, and fragrances to minimize skin irritation. For young children, warm water alone is often sufficient for cleaning, without the need for soap or bubble bath, which can be harsh on their skin. Avoid deodorant and antibacterial soaps, as they can strip the skin of natural oils and contribute to dryness. Avoid vigorous scrubbing with washcloths or loofahs.
• Pat dry and moisturize: After bathing, gently pat your skin dry with a soft towel. Apply moisturizer while your skin is still damp, within three minutes of bathing, to help seal in moisture effectively.

Diagnosis:

To diagnose atopic dermatitis, healthcare providers typically engage in discussions regarding symptoms, conduct thorough skin examinations, and review medical histories. Additional diagnostic methods may include:

• Allergy testing: Assessing for allergens through skin prick tests or blood tests can help identify triggers for eczema flares.
• Skin biopsy: In some cases, a small sample of skin may be taken for examination under a microscope to rule out other skin conditions and confirm a diagnosis of atopic dermatitis.
• Observation of symptoms: Tracking the progression and patterns of eczema symptoms over time can aid in diagnosis and treatment planning.
• Evaluation of family history: Since atopic dermatitis often runs in families, assessing the presence of similar conditions among close relatives can provide valuable diagnostic insights.
• Patch testing: This procedure involves applying small amounts of various substances to the skin, which are then covered. Over subsequent visits spanning several days, the doctor examines the skin for signs of a reaction. Patch testing can be instrumental in identifying specific allergens responsible for dermatitis. Top of Form

Treatment

Treatment for atopic dermatitis often begins with adopting regular moisturizing routines and other self-care practices. If these measures prove ineffective, healthcare providers may recommend medicated creams to alleviate itching and promote skin repair. These creams are sometimes complemented with additional treatments.

Managing atopic dermatitis can be challenging as it may require trying various treatments over an extended period. Even if treatment initially succeeds, symptoms may recur (flare).

Medications:

• Topical medications: These products come in various strengths and formulations such as creams, gels, and ointments. They help control itching and repair the skin. It's essential to apply them as directed, typically twice daily before moisturizing. Overuse of corticosteroid products can lead to side effects like skin thinning.
• Calcineurin inhibitors: Creams or ointments containing calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel), may be suitable for individuals over the age of 2. It is crucial to apply them as directed and avoid strong sunlight during use.
• Drugs to fight infection: In cases of infection, healthcare providers may prescribe antibiotic pills.
• Pills to control inflammation: For severe eczema, pills like cyclosporine, methotrexate, prednisone, mycophenolate, and azathioprine may be prescribed. However, these medications cannot be used long-term due to potential serious side effects.
• Injectable biologics: Drugs like dupilumab (Dupixent) and tralokinumab (Adbry) may be options for individuals with moderate to severe eczema who do not respond well to other treatments. These are safe and effective in easing symptoms, with dupilumab approved for use in individuals over age 6 and tralokinumab for adults.

Therapies:

• Wet dressings: An intensive treatment involving the application of a corticosteroid ointment under wet gauze wraps. This method is typically administered in a hospital setting due to its labor-intensive nature.
• Light therapy: Controlled exposure to natural sunlight or artificial ultraviolet light, either alone or in conjunction with medications, may be utilized in individuals who do not respond to topical treatments.
• Counseling and behavioral interventions: Seeking support from a therapist or counselor can help manage the emotional impact of atopic dermatitis, while relaxation techniques and behavior modification strategies may help reduce scratching habits.

For baby eczema (infantile eczema), treatment strategies include identifying and avoiding skin irritants, regulating temperature exposure, and employing gentle skincare practices. If these measures fail to improve the rash or if it appears infected, prescription medications may be necessary. In some cases, oral antihistamines may be recommended to alleviate itching and promote sleep, although their sedative effects may impact daytime performance in some children.

Conclusion

In summary, eczema, or dermatitis, presents with symptoms like redness, itching, and dryness, impacting daily life significantly. Complications include skin infections and mental health issues. Diagnosis involves medical history review and examination, sometimes including allergy testing. Treatment options range from moisturizing to medicated creams and therapies like light therapy. Collaborating with healthcare providers is crucial for effective management and improved quality of life.