Atopy is the predisposition to develop hypersensitivity reactions in case of contact with substances that are generally harmless.

Atopic dermatitis is a chronic disease that presents with skin plaques:

  • Thick,
  • Dry ,
  • Outgoing.

From time to time, most people have an outbreak characterized by:

Atopic dermatitis affects up to 20% of children and infants (in 90% of cases appear within the first 5 years of life). 
Only 3% of adults suffer from atopic eczema.

It is a chronic disease that can be accompanied by:

Other forms of eczema include:

Causes of Atopic Eczema

The causes of atopic dermatitis are unknown, but the origin is believed to be genetic. 
People with atopic dermatitis may be more sensitive because their skin is deficient in some proteins .

A research from the University of Newcastle in Britain, led by Nick Reynolds, found that protein deficiency of filaggrin can cause eczema.

People with atopic dermatitis are often positive for allergy skin testing. 
However, atopic dermatitis is not caused by an allergy .

The following are the factors that can aggravate the symptoms of atopic dermatitis: 
1. Allergy to

  • Pollen,
  • Mofo,
  • Dust mites,
  • Hairs of animals,
  • Nickel,
  • Formaldehyde,
  • Food (food allergy, such as: milk, crustaceans, etc.).

2. Cold and dry air in the winter; 
3. Seasonal flu and  colds ; 
4. Contact with irritating substances or chemicals; 
5. Contact with raw materials, such as wool ; 
6. Dry skin ; 
7.  Emotional stress ; 
8. Pregnancy, atopic dermatitis may appear or worsen during this period; 
9. Wipe the scrubbing skin after taking lots of baths; 
10. Swim for a long time in the pool and do not rinse the chlorine well; 
11. Very hot or very cold weather or sudden changes in temperature;
12. In case of a beach holiday, care must be taken because if the disease is in the acute stage, the salinity and the sun can aggravate the situation. 
If the dermatitis is in remission, the child may have an improvement in a beach house. 
13. Perfumes or dyes added to soaps or skin lotions. 
14. Research shows that there may be a  psychic component in the onset of atopic dermatitis.

 

Signs and Symptoms of Eczema

The signs and symptoms of eczema vary widely in the early stages. 
The symptoms in children are different from the symptoms in adults. Red, open, or crusted skin lesions
may also form  on the affected area.

 

What does atopic dermatitis look like?

  • There are many differences in the eczema aspect among individuals.
  • From time to time, most people have an exacerbation with the formation of white patches  ( pityriasis alba) or red and swollen.
  • Sometimes bubbles develop that transude.
  • Between relapses, the skin may appear normal, or it is possible for the person to suffer from chronic eczema with  areas of skin:
    • Dry,
    • Thickened
    • With itching.

The way eczema appears and is felt may change depending on:

  • The presence of an infection or other skin disease,
  • The applied creams,
  • The age of the person,
  • The skin color,
  • Other factors.

However, there are some areas of the body in which eczema forms depending on the age of the person concerned.

 

 

Atopic dermatitis in newborns

1. Babies under one year old often have eczema scattered throughout the body . Generally, the skin stays:

  • Dry ,
  • Rachada,
  • Red with small cuts made by the child’s nails.

2. Often, babies’ cheeks are the first area to be affected by eczema. Then the rash appears on the forehead, chin and around the ears .

3. Generally, the anal area is not affected by moisture retention of the nappies. 
Like other children, irritant dermatitis of the anal and perianal region (diaper rash) can develop if wet or dirty diapers remain in contact with the skin for a long time.

4. Eczema in this age group often affects the area of ​​skin where the muscles that extend the joints are , especially

  • Elbows, where you can feel the bone,
  • Knees , in front of the patella.

5.  Other parts of the body of the newborn affected by atopic dermatitis are:

  • The chest,
  • The arms (forearm),
  • The neck.

 

Atopic dermatitis or eczema in children

Pre-school children

1. When children start walking, eczema becomes more localized and thicker . 
Small children scratch vigorously eczema that can look very hard and cause discomfort.

2. When the child grows (from two years of age), the model changes and involves almost only the skin of the flexor faces of the joints (internal), for example behind the knee. 
Often, the affected skin becomes lichenified, ie dry and thickened due to:

  • Scratches,
  • F riction .

3. In some children, the eczema model on the external side of the joint persists in the next phase of childhood.

Atopic dermatitis or eczema

School-age
children Larger children tend to have the eczema model in the flexor muscles and it mainly affects the folds of:

  • Elbows,
  • Knees.

Other sensitive areas are:

  • Neck,
  • Scalp
  • Face, especially:
    • Eyelids,
    • Corners of the mouth,
    • Ear lobes.

It is possible to develop acute itchy blisters on the palms and recurrent, fingers of hands and sometimes the feet, known as disidrótica or vesicular dermatitis . 
Many children develop a “numular” model of atopic eczema. This refers to small coin-like areas scattered throughout the body. 
These round spots of eczema are:

  • Dry,
  • With itching,
  • Red.

These spots can be mistaken for mycosis ( yeast infection ). 
Mostly eczema improves during the school years and may disappear altogether during adolescence, although the skin barrier function may not become completely normal. 
The skin may become more sensitive to irritation.

Eczema in adolescents and adults

1. Young people and adults who have eczema may have different manifestations. 
2. They may continue to have a generalized model of dermatitis, but the skin is generally drier and lichen compared to children. 
3. Generally, adults have persistent localized eczema, limited to:

  • Back of the hands and feet,
  • Eyelids,
  • Internal side of elbows and knees,
  • Nipples,
  • Nut,
  • Anogenital region (especially adolescents).

Some people develop injuries in all of these areas together. 
Some people develop eczema in other parts of the body, such as:

  • The hips,
  • The legs.

4. Recurrent staphylococcal infections can be clearly visible. Cutaneous lesions caused by atopic dermatitis may favor the onset of skin infections: germs penetrate more easily and infect the lesions.

5. Atopic dermatitis is an important factor that promotes irritative contact dermatitis in the workplace . 
It usually affects the hands, which are often exposed to:

  • Water,
  • Detergents,
  • Solvents

Sometimes the areas affected by eczema do not have itching.

6. Adult dermatitis tends to be dry and thickened, but there may also be some blisters.

 

Diagnosis of atopic dermatitis

Diagnosing eczema can be difficult because:

1. Each child has a unique combination of symptoms that can be mild or severe.

2. Sometimes it is confused with other skin diseases such as:

  • Seborrheic dermatitis in the newborn (better known as “milk crust”),
  • Psoriasis (an autoimmune disease that causes scaly and inflamed skin),
  • Contact dermatitis (caused by direct skin contact with an irritant, metal, medicine, or soap).

3. No test is available to definitively diagnose eczema.

4. If the doctor suspects the presence of eczema, the most valuable diagnostic tool is the complete medical history. 
The familiarity of hay fever, allergies or asthma is often an important clue.

5. Tests that the doctor prescribes are:

  • The dosage of the IgE antibodies,
  • Prick test (skin allergy skin test),
  • Contact tests (application of adhesive tapes containing common allergens in the back).

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