Overview
Atopic dermatitis, also called atopic eczema, is a skin disorder that usually manifests itself as dry, itchy skin and/or a red, scaly rash. The term "atopic" refers to an allergic or immunologic reaction; "dermatitis" and "eczema" both mean inflammation of the skin. Atopic dermatitis is common, affecting 10 to 20 percent of the population in the U.S. It most often affects infants and small children, although it also strikes teenagers and adults. It may be the first sign that a person will go on to develop other atopic conditions such as hay fever or asthma.
The disease can have a significant impact on the quality of life of individuals and their families. The itching can interfere with daily activities and make it hard to sleep. Scratching the rash can irritate the skin, making it itch even more, which, in turn, increases the tendency to scratch. This itch-scratch cycle can leave the skin open to infections.
There is no cure for atopic dermatitis, but there are many ways to treat it. For instance, discovering and avoiding triggers, such as fragrances or detergents that cause the illness to "flare," is vital, as is good daily care, which usually involves soaking the skin and then applying a moisturizer or medicine, such as a steroid cream or ointment. Shampoos with antidandruff action or tar products to lower inflammation can be helpful. Also, oral sedating antihistamines to control itching may be prescribed for use at bedtime.
People who seek out and get good treatment often succeed in controlling their eczema and so are able to feel good about their appearance, have restful sleep, and participate fully in family, school, and work activities.
Need-to-know anatomy
People with the condition often have skin that is less able to retain moisture than normal skin so it often feels dry and looks red. Eczema usually appears as a dry, scaly rash on the skin.
In places where there have been repeated rashes, the skin can take on a wooden, thicker appearance. This is known as
lichenification
. Rashes may also have a cracked appearance and weep a clear fluid.
Causes
The causes of atopic dermatitis are not currently known but it seems to run in families, so there is probably a genetic component. In general, people with this condition have skin that dries out more readily than normal. In addition, irritants or allergens-things that make the condition flare up-may be uncovered for each person. They can include soaps and fragrances and foods. Also emotional stress and extremes in temperature and humidity can prompt flare-ups.
Risk factors
There are several risk factors for the condition that are not under a patient's control, including:
-
A family history of the disease
-
A personal history of allergic conditions, such as hay fever
-
A personal history of asthma
-
A personal history of food allergies
These conditions appear to be part of a series of immune disorders called the "
atopic march
." Over a period of years, a person may develop one and than another. Recognizing that a person with eczema is at a higher than normal risk of developing another of these conditions is important for parents, patients, and healthcare providers. Knowing that a patient with a slight wheeze has had a history of atopic dermatitis, for example, makes it easier to diagnose the subtle onset of asthma.
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