Atopic Dermatitis

What is atopic dermatitis?

Atopic dermatitis is a rash that occurs in up to 20% of infants and 3% of the U.S. population as a whole. The rash presents usually as an itching dermatitis which can lead to intense burning and discomfort. With time, atopic dermatitis improves. However, approximately 60% of those who develop the disorder in childhood have some degree of eczema that occurs throughout their lifetime.

Fig. 1

Atopic Dermatitis-is a type of eczema which affects the flexure areas of arms and legs. Skin tends to be dry and  "lusterless"

What aggravates atopic dermatitis?

Direct manipulation of eczematous areas can promote secondary infection and aggravate the condition. It is important to avoid placing irritating substances on the skin, such as alcohol, propylene glycol, or lanolin based products. These agents can intensify the rash. The use of emollients and topical corticosteroid creams along with reducing water temperature can be useful in treating the disorder.

Fig. 2

Atopic Dermatitis-White patches on face can be seen in this condition-referred to as Pityriasis Alba

How does one recognize atopic dermatitis?

When assessing atopic dermatitis it is important to determine whether or not the patient has a history of hay fever, pollen or dust allergies. The skin of those with atopic dermatitis is described as "dull or lusterless". The rash often occurs behind the elbows or knees. In younger patients, dermatitis involves the scalp and the face. Patients often have increased line markings of the hands and crusting spots on the fingers.

Fig. 3

Atopic Dermatitis-  may affect the face area in children

What other factors can aggravate atopic dermatitis?

Interestingly, there are certain food groups which can aggravate this type of rash, especially in younger children. Food products containing milk, soy, eggs, fish, wheat or peanuts have been implicated. If one suspects a food intolerance, it is important to avoid these products for at least one to two weeks to see if the rash improves. Allergy testing is sometimes required.

Fig. 4               

Atopic Dermatitis-skin is very dry and easily irritated with fragrances or wool products.

What are some of the environmental factors that should be avoided?

Pillows, down comforters and mattresses that contain feathers can often make symptoms worse. It is important to consider the materials that contact the skin when assessing atopic dermatitis. Patch testing is also sometimes helpful. This is a way to see which chemical or agents are responsible for rash development.

Are allergy shots helpful in the treatment of atopic dermatitis?

Not usually. In fact, they sometimes cause the dermatitis to become more intense.

• To review:

  Atopic dermatitis is a common skin rash that can be seen in up to twenty percent of the population. Dermatitis is manageable with moisturizers and corticosteroid creams.
  
  If you have any questions, or wish to schedule a consultation, please call  Ponte Vedra Dermatology & Aesthetic Surgery at (904) 285-7546 or email consultation@pvderm.com

  FURTHER INFORMATION For more information and to  learn about new medications, important ways to control your eczema and associated disorders, please click on www.eczema-assn.org.