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Atopic Dermatitis - Pictures And Treatment

Causes of Atopic dermatitis

Several theories attempt to explain the pathogenesis of this disorder, which has an unknown cause. One theory suggests an underlying metabolically or bio­chemically induced skin disorder that's genetically linked to elevated serum immunoglobulin E (lgE) levels; another suggests defective T-cell function.

Exacerbating factors of atopic dermatitis include irritants, infections (commonly caused by Staphylococcus aureus), and some allergens. Although no reliable link exists between atopic dermatitis and exposure to inhalant allergens (such as house dust and animal dander), exposure to food allergens (such as soybeans, fish, or nuts) may coincide with flare-ups of atopic dermatitis.

Signs and symptoms of Atopic dermatitis

Scratching the skin causes vasoconstriction and intensifies pruritus, resulting in erythematous, weeping lesions. Eventually, the lesions become scaly and lichenified. Usually, they're located in areas of flexion and extension, such as the neck, antecubital fossa, and popliteal folds, and behind the ears. Patients with atopic dermatitis are prone to unusually severe viral infections, bacterial and fungal skin infections, ocular complications, and allergic contact dermatitis.

Diagnosis

Treatment of Atopic dermatitis

Measures to ease this chronic disorder include meticulous skin care, environmental control of offending allergens, and drug therapy.

Vaseline and cortisone compounds applied to the skin are the best medicines for controlling eczema. Most cortisone salves can be used safely for years. When large areas of the body are treated with strong cortisone preparations, periodic medical check ups are necessary. Strong cortisones shouldn't be applied to the face, armpits, groin, or rectal area.

CLINICAL TIP Because dry skin aggravates itching, frequent application of nonirritating topical lubricants is important, especially after bathing or showering. Minimizing exposure to allergens and irritants, such as wools and harsh detergents, also helps control symptoms.

Drug therapy involves corticosteroids and antipruritics. Active dermatitis responds well to topical corticosteroids, such as fluocinolone acetonide and flurandrenolide. These drugs should be applied immediately after bathing for optimal penetration. Oral antihistamines, especially the phenothiazine derivatives, such as methdilazine and trimeprazine, help control itching. A bedtime dose of antihistamines may reduce involuntary scratching during sleep. If a secondary infection develops, antibiotics are necessary.

Because this disorder may frustrate the patient and strain family ties, counseling may playa role in treatment

Special considerations and prevention

• Monitor the patient's compliance with drug therapy.
• Teach the patient when and how to apply topical corticosteroids.
• Emphasize the importance of good personal hygiene.
• Be alert for signs and symptoms of secondary infection; teach the patient how to recognize them as well.
• If the patient's diet is modified to exclude food allergens, monitor his nutritional status.
• Discourage the use of laundry additives.
• Offer support to help the patient and his family cope with this chronic disorder.

Related Information

• Dyshidrotic Dermatitis
• Dermatitis herpetiformis