It is a common skin condition, with intense itching as its main symptom. In dermatology, the term “dermatitis” is synonymous with “eczema.” Atopic dermatitis is a chronic, inflammatory skin condition characterized by periods of flare-ups and remissions. In children with atopic dermatitis, the skin barrier is dysfunctional, leading to dry, scaly, and itchy skin.
The exact pathogenesis of atopic dermatitis is not fully understood, but it appears to result from an interaction between genetic and environmental factors. In other words, the infant is born with a genetic predisposition, and environmental triggers—such as food allergens, airborne allergens, etc.—lead to the manifestation of the dermatitis.
Usually, one or both of the child’s parents have one or more of the following conditions: atopic dermatitis, bronchial asthma, allergic rhinitis, or allergic conjunctivitis.
Atopic dermatitis occurs very frequently. It usually first appears in infancy or childhood.
At least 15 to 20% of children develop atopic dermatitis at some point during childhood, most commonly in the first year of life. In our country, the incidence of the disease is 10% with an increasing trend.
Depending on the age of the patient, three types are distinguished:
Infantile atopic dermatitis:
It begins around the age of 3 months and is characterized by a prominent rash on the cheeks, accompanied by intense itching. Skin lesions may also appear on the body.Childhood atopic dermatitis:
This form includes ages from 4–5 years up to adolescence. Skin lesions are typically found on the flexural surfaces of the elbows and knees, on the sides of the neck, and on the eyelids. Dryness is observed across the entire surface of the body.
- Adult atopic dermatitis:
Its main features are dry skin, inflammation, and lichenification (thickening and hardening) of the flexural surfaces of the upper and/or lower limbs.
Inflammation is often observed around the eye area or on the neck.
A very commonly affected area is the hands, as they are frequently exposed to irritants during occupational and household activities.
Atopic dermatitis is a chronic condition characterized by flare-ups and remissions, but over time, it tends to improve.
Common factors that can aggravate people with atopic dermatitis are:
Stress
Sweating
Environmental pollution
Coexisting allergies
Certain body cleansers, shampoos, and detergents
Prolonged hot baths
Dry skin
Sudden temperature changes
Woolen and synthetic clothing, blankets, and carpets
Dust or sand
Cigarette smoke
Certain foods in the presence of an allergic background
Bacterial superinfection of the lesions
The choice of treatment for the disease depends on the patient’s age and clinical presentation. To control itching, oral antihistamines are administered. During the acute phase, corticosteroids (topical and/or oral) are prescribed for a specific period to ensure disease control. Calcineurin inhibitors are medications with an action similar to that of corticosteroids. In addition, treatment for atopic dermatitis may include antibiotics, both topical and oral. There is no treatment that provides immediate and permanent cure. However, with appropriate therapy and medication, the disease can be adequately controlled and remain in remission.
Parents of a child with atopic dermatitis should take the following precautions:
Keep the child’s skin well moisturized at all times. There are special products designed for this purpose.
Keep the child’s nails short and clean.
Avoid using very hot water during baths, as it can worsen the dermatitis.
After bathing, gently pat the child’s skin dry rather than rubbing.
Choose cotton clothing for the child; avoid wool or synthetic fabrics.
The child’s room should be free of carpets or rugs and cleaned with a vacuum cleaner. Plush toys should be avoided.
Ensure emotional calm, as psychological stress can aggravate the condition.
Parents should understand the chronic nature of the disease and strictly follow the dermatologist’s instructions.
It is advisable to avoid swimming in pools when the child is experiencing a flare-up, as chlorine can irritate the skin and worsen atopic dermatitis. For this reason, parents should always consult their treating dermatologist for guidance.
No, atopic dermatitis is a chronic disease that is not contagious, however it is often hereditary.