What is Atopic Dermatitis
Atopic dermatitis represents an itchy, chronic and inflammatory skin disorder, whose onset often coincides with the pediatric age. The name "atopic", attributed to dermatitis, emphasizes the absence of a particular cutaneous position: the term, in fact, derives from the Greek "a-topos", which means, precisely, devoid of a specific place .
See other Photos Atopic Dermatitis
The atopic term was coined in 1923 by A. Coca and R. Cooke. A few years earlier, in the late 1800s, dermatologists Leonard Marie Lucien Jacquet and Lois Anne Jean Brocq found that this skin disorder was often associated with a strong and marked emotional component; in this regard, what we now know as atopic dermatitis was originally called disseminated neurodermatitis .
Incidence
Surely infants are exposed to a greater risk: their immune system is not yet well formed, which is why the chances of contracting atopic dermatitis in the first months of life are high.
Atopic dermatitis is one of the most problematic conditions in industrialized countries, affecting 20% of children and 3% of adults. According to statistics, the cases of asthma related to atopic dermatitis are three times higher in rich countries than in developing countries.
Statistically, a greater incidence of atopic dermatitis has been recorded in subjects particularly sensitive to allergic disorders such as asthma or hay fever.
Features
Characteristics of Atopic Dermatitis
Atopic dermatitis differs from other forms of dermatitis because the cutaneous manifestations related to it do not coincide with the areas in which a given substance is placed in contact with the skin. Atopic dermatitis does not only manifest itself in the skin, but it also progresses by affecting the mucous membranes: as mentioned above, in fact, in most affected individuals recurrent episodes of asthma, rhinitis and allergic rino-conjunctivitis, in conjunction with rash and itching .
Onset and Evolution
In most cases, the onset of atopic dermatitis occurs within the first five years of life, while this disease rarely begins in adult or advanced age.
Generally speaking, in the early stages, atopic dermatitis is manifested by dryness of the skin, redness and itching in the face, legs and trunk.
Subsequently, with growth, dermatitis tends to affect the same areas, but the skin appears drier and tends to flake. However, in some cases the disease tends to disappear spontaneously in adolescence.
However, the course of atopic dermatitis still tends to be chronic-relapsing. This means that periods of improvement alternate with periods in which the disorder becomes more or less severe.
Symptoms
To learn more: Symptoms Atopic Dermatitis
As mentioned, the course of atopic dermatitis tends to be chronic-relapsing. For this reason, the symptoms can vary during the various phases of the patient's life.
At the time of its onset - in the so-called acute phase - atopic dermatitis manifests itself with symptoms, such as:
- Dryness of the skin;
- rashes;
- vesicles;
- Eczema;
- Crusts.
As the patient grows, the disease proceeds and, in cases where it does not regress spontaneously, it becomes chronic, leading to more severe symptoms, such as:
- Thickening of the skin that leads to the creation of lichenified areas and papules;
- hyperkeratosis;
- fissures;
- Intense and unbearable itching, so much so that the affected subject fails to avoid rubbing the affected area continuously, further worsening the pre-existing situation.
Furthermore, the skin appears more susceptible to bacterial infections: in fact, eczema is aggravated by contact with bacteria, which more easily penetrate the skin finding a locus suitable for proliferation. This situation occurs, a fortiori, in the presence of bleeding fissures.
Seasonality
Relationship between Atopic Dermatitis and Seasonality
A greater incidence of atopic dermatitis has been recorded in the winter months, while in summer the condition, in some cases - but not in all - regresses. The sun is probably a possible remedy to reduce the disturbance. On the other hand, excessive sun exposure could be harmful to the skin and worsen the rash: according to the opinion of the doctor, it is therefore recommended to have a correct exposure to the sun's rays for short periods, after applying creams with sun filters high protection.
Causes
Atopic dermatitis is a multifactorial disease, since the causes that trigger it are many and varied: the etiology is researched in genetics, in the psychosomatic state of the subject and in the surrounding environment, to which food and inhaled allergens refer, skin infections, stress, sweating and exposure to irritants.
In particular, the genetic and environmental components act almost in symbiosis, enhancing the inflammatory hyperactivity of the skin towards the allergens.
The ferocious itching caused by atopic dermatitis leaves lesions on the skin, since the subject tends to rub the injured area continuously: the skin, therefore, appears dry and arid. It seems that the cause of dehydration of the skin is due to alterations in the activity of the enzyme 6-gamma-reductase, implicated in the metabolism of omega 6, a category of essential fatty acids used - among other things - for the physiological maintenance of the hydrolipidic film, skin protection barrier.
Diagnosis
The clinical analysis of the lesions, by the dermatologist, is the means to diagnose atopic dermatitis: the examination of the injured tissues (biopsy) is carried out only in some cases, aimed at excluding the presence of more serious pathologies. The diagnosis, as in the case of allergic dermatitis, should be carried out with Patch Test : also in this case, the analysis involves the application on the skin of potentially allergenic substances. and subsequent analysis after 48 and 72 hours. There is also another form of patch test, called Atopy Patch Test, which examines allergens such as dust mites and grasses through the application of special patches. In addition to the patch tests, the patient can undergo other tests such as PRIST and RAST (respectively, total IgE dosage - type E immunoglobulins - and specific IgEs) and the PRICK test (possible allergens are applied at the level of the forearm foodstuffs such as soy, wheat, cow's milk, peanuts, fish etc).
Important is the search for other disorders related to atopic dermatitis, such as rhinitis, asthma and rino-conjunctivitis, since, as already analyzed, atopic respiratory diseases often represent the immediate consequence of the skin disorder.
Treatment
See also: Eczema medications
The therapies aimed at resolving or improving atopic dermatitis must be chosen based on the severity of the condition, the age of the patient and his psychological state, the concomitant presence of other pathologies and the needs of the subject.
However, complete resolution of the disorder is not very frequent, especially if the patient is an adult. In fact, pharmacological therapies often resolve the condition only momentarily. Possible remedies can be summarized as:
- Application of pharmaceutical formulations - creams, ointments, lotions or foam - based on corticosteroids, a classic remedy effective especially in acute forms of atopic dermatitis.
- Emollient substances to be applied to damaged skin, free of allergenic or irritating substances: for example, creams based on essential fatty acids, which contribute to the physiological maintenance of the hydrolipidic film, could be preferred.
- Antihistamines , antivirals and antibiotics (systemic therapy, which exerts its action from within).
- Antiseptic substances .
- UVA phototherapy ; UVB; combined UVA / B.
The use of corticosteroids, supported by the use of emollient creams, is a very effective combination to improve the symptoms caused by atopic dermatitis.
Despite the numerous and varied therapies available, there are no natural treatments or pharmacological or phototherapeutic treatments that ensure complete elimination of atopic dermatitis.
Useful tips
Useful tips and tricks to prevent the manifestations of Atopic Dermatitis
Although complete recovery from atopic dermatitis is difficult, to limit its annoying manifestations and reduce its symptoms, it may be useful to adopt some behavioral measures and follow a few useful tips.
First of all, it is advisable to take care of the skin using delicate and high quality products that do not attack it. In this regard, proper body hygiene (carried out by the use of delicate cleansers for sensitive skin, possibly even prescribed by a doctor) is essential for reducing the recurrent forms of atopic dermatitis.
Body hygiene, then, should be associated with the use of suitable clothing made of cotton or natural fiber clothing and without clothes made of synthetic material and / or too tight that could further irritate the skin.
Particular care must also be taken in the choice of cosmetics and make-up products that must be strictly quality, possibly without fragrances or other allergenic substances that could further worsen the clinical picture of atopic dermatitis.
If despite the adoption of the aforementioned measures, the atopic dermatitis worsens and manifests itself frequently, it is necessary to contact the doctor who will be able to evaluate the possible use of drug therapies.
