Atopic dermatitis (AD), also known as atopic eczema, is a type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thicken over time.[1] The condition typically starts in childhood with changing severity over the years.[1][2] In children under one year of age much of the body may be affected. As people get older, the back of the knees and front of the elbows are the most common areas affected. In adults the hands and feet are the most commonly affected areas.[2] Scratching worsens symptoms and affected people have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.[1]
The cause is unknown but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin.[1][2] If one identical twin is affected, there is an 85% chance the other also has the condition.[3] Those who live in cities and dry climates are more commonly affected. Exposure to certain chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse it is not a cause. The disorder is not contagious.[1] The diagnosis is typically based on the signs and symptoms. Other diseases that must be excluded before making a diagnosis include contact dermatitis, psoriasis, and seborrheic dermatitis.[2]
Treatment involves avoiding things that make the condition worse, daily bathing with application of a moisturising cream afterwards, applying steroid creams when flares occur, and medications to help with itchiness.[2] Things that commonly make it worse include wool clothing, soaps, perfumes, chlorine, dust, and cigarette smoke. Phototherapy may be useful in some people. Steroid pills or creams based on calcineurin inhibitors may occasionally be used if other measures are not effective.[1][4] Antibiotics (either by mouth or topically) may be needed if a bacterial infection develops.[2] Dietary changes are only needed if food allergies are suspected.[1]
Atopic dermatitis affects about 20% of people at some point in their lives.[1][5] It is more common in younger children.[2] Males and females are equally affected.[1] Many people outgrow the condition.[2] Atopic dermatitis is sometimes called eczema, a term that also refers to a larger group of skin conditions.[1] Other names include "infantile eczema", "flexural eczema", "prurigo Besnier", "allergic eczema", and "neurodermatitis".[6]
People with AD often have dry and scaly skin that spans the entire body, except perhaps the diaper area, and intensely itchy red, splotchy, raised lesions to form in the bends of the arms or legs, face, and neck.[7][8][9][10][11]
AD commonly occurs on the eyelids where signs such as Dennie-Morgan infraorbital fold, infra-auricular fissure, periorbital pigmentation can be seen.[12] Post-inflammatory hyperpigmentation on the neck gives the classic 'dirty neck' appearance. Lichenification, excoriation and erosion or crusting on the trunk may indicate secondary infection. Flexural distribution with ill-defined edges with or without hyperlinearily on the wrist, finger knuckles, ankle, feet and hand are also commonly seen.[13]
The cause of AD is not known, although there is some evidence of genetic factors, and some evidence that growing up in a sanitary environment encourages AD.[8]
It seems to have a genetic component. Many people with AD have a family history of atopy. Atopy is an immediate-onset allergic reaction (type 1 hypersensitivity reaction) as asthma, food allergies, AD or hay fever.[7][8] In 2006 it was discovered that mutations in the gene for the production of filaggrin strongly increased the risk for developing atopic dermatitis. Most importantly two mutations were found that affect approximately 5% of people in Western Europe that may disrupt the production of filaggrin. Filaggrin is a protein that plays an important role in the retention of water in the stratum corneum. People who have these mutations often have dry skin.[14] Filaggrin also plays an important role in keeping the skin surface slightly acidic, hence giving it anti-microbial effects. It breaks down into trans-urocanic acid, which keeps the pH low.[15]
According to the hygiene hypothesis, when children are brought up exposed to allergens in the environment at a young age, their immune system is more likely to tolerate them, while children brought up in a modern "sanitary" environment are less likely to be exposed to those allergens at a young age, and, when they are finally exposed, develop allergies. There is some support for this hypothesis with respect to AD.
Those exposed to dogs while growing up have a lower risk of atopic dermatitis.[16] There is also support from epidemiological studies for a protective role for helminths against AD.[17] Likewise children with poor hygiene are at a lower risk for developing AD, as are children who drink unpasteurised milk.[17] Exposure to dust mites is believed to contribute to one's risk of developing AD.[18]
A diet high in fruits seems to have a protective effect against AD, whereas the opposite seems true for fast foods.[17]
Atopic dermatitis sometimes appears associated with celiac disease and non-celiac gluten sensitivity.[19][20]
An atopy patch test can be used to determine whether or not a specific allergen is the cause of the rash. The test involves applying a series of allergens to the skin surface and evaluating the results in one to three days.[21][22]
People with atopic dermatitis are more likely to have Staphylococcus aureus living on them.[23]
There is no known cure for AD, although treatments may reduce the severity and frequency of flares.[7]
Applying moisturisers may prevent the skin from drying out and decrease the need for other medications.[24] Affected persons often report that improvement of skin hydration parallels with improvement in AD symptoms.[7]
Health professionals often recommend that persons with AD bathe regularly in lukewarm baths, especially in salt water, to moisten their skin.[8][25] Avoiding woollen clothing is usually good for those with AD. Likewise silk, silver-coated clothing may help.[25] Dilute bleach baths have also been reported effective at managing AD.[25]
Vitamin D is an effective treatment for AD.[26]
Studies have investigated the role of long chain polyunsaturated fatty acids (LCPUFA) supplementation and LCPUFA status in the prevention and treatment of atopic diseases, but the results are controversial. It remains unclear if the nutritional intake of n-3 fatty acids has a clear preventive or therapeutic role, or if n-6 fatty acids consumption promotes atopic diseases.[27]
Several probiotics seem to have a positive effect with a roughly 20% reduction in the rate of atopic dermatitis.[28] The best evidence is for multiple strains of bacteria.[29]
In people with celiac disease or non-celiac gluten sensitivity, a gluten free diet improves their symptoms and prevents the occurrence of new outbreaks.[19][20]
Topical corticosteroids, such as hydrocortisone have proven themselves effective in managing AD.[7][8] If topical corticosteroids and moisturisers fail, short-term treatment with topical calcineurin inhibitors like tacrolimus or pimecrolimus may be tried, although they are usually avoided as they can cause skin cancer or lymphoma.[7][30] Alternatively systemic immunosuppressants may be tried such as ciclosporin, methotrexate, interferon gamma-1b, mycophenolate mofetil and azathioprine.[7][31] Antidepressants and naltrexone may be used to control pruritus (itchiness).[32]
A more novel form of treatment involves exposure to broad or narrow-band ultraviolet (UV) light. UV radiation exposure has been found to have a localized immunomodulatory effect on affected tissues and may be used to decrease the severity and frequency of flares.[33][34] In particular, the usage of UVA1 is more effective in treating acute flares, whereas narrow-band UVB is more effective in long-term management scenarios.[35] However, UV radiation has also been implicated in various types of skin cancer, and thus UV treatment is not without risk.[36]
Since the beginning of the twentieth century, many mucosal inflammatory disorders have become more common; atopic eczema (AE) is a classic example of such a disease. It now affects 1530% of children and 210% of adults in developed countries and in the United States has nearly tripled in the past thirty to forty years.[8][37] Over 15 million American adults and children have atopic dermatitis.[38]
Evidence suggests that IL-4 is central in the pathogenesis of AD.[39] Therefore, there is a rationale for targeting IL-4 with anti-IL-4 inhibitors.[40]
Diseases of the skin and appendages by morphology
Continued here:
Atopic dermatitis - Wikipedia
- How To Cure Eczema: Tips To End The Pain And Discomfort Once And For All - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Helping Kids with Severe Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Eczema - Going Dairy Free - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Eczema Treatment - Start Your Eczema Treatment Today - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- CURED ECZEMA! - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Eczema Cure - Eczema Cure With The Eczema Diet - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Treatment for Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- How To Get Rid Of Eczema Treatment - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Eczema: Three Foods That Cause Eczema Breakouts - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Understanding Baby Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Dermatology Treatments : How to Get Rid of Eczema on the Scalp - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Dermatology Treatments : How to Treat Severe Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- eczema or atopic dermatitis - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Dealing with Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Itchy Skin and Eczema - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- How to Treat Eczema [DermTV.com Epi #178] - Video [Last Updated On: September 7th, 2012] [Originally Added On: September 7th, 2012]
- Spot the Difference: Eczema Versus Fungal Skin Infection [Last Updated On: September 8th, 2012] [Originally Added On: September 8th, 2012]
- HayleyBee90 published Miracle Skincare from Liz Earle [Last Updated On: September 8th, 2012] [Originally Added On: September 8th, 2012]
- 10 Easy Ways to Prevent Eczema Flare-Ups [Last Updated On: September 10th, 2012] [Originally Added On: September 10th, 2012]
- Malaya Business News Online | Philippine Business News [Last Updated On: September 10th, 2012] [Originally Added On: September 10th, 2012]
- Don't Stress about Eczema [Last Updated On: September 13th, 2012] [Originally Added On: September 13th, 2012]
- Time to Bid Eczema Good Night [Last Updated On: September 15th, 2012] [Originally Added On: September 15th, 2012]
- CapriClear® Awarded the National Eczema Association NEA Seal of Acceptance™ [Last Updated On: September 20th, 2012] [Originally Added On: September 20th, 2012]
- The Sensitive Skin Diaries: Acne, Rosacea & Eczema Explained [Last Updated On: September 27th, 2012] [Originally Added On: September 27th, 2012]
- Priority Health: Eczema [Last Updated On: September 28th, 2012] [Originally Added On: September 28th, 2012]
- Itchy protease! [Last Updated On: September 30th, 2012] [Originally Added On: September 30th, 2012]
- The International Topical Steroid Addiction Network Patient’s Story About Curing Eczema Featured in the Eczema ... [Last Updated On: October 3rd, 2012] [Originally Added On: October 3rd, 2012]
- The Eczema Company Pledges Donation for National Eczema Awareness Month [Last Updated On: October 5th, 2012] [Originally Added On: October 5th, 2012]
- 8 new susceptibility loci for eczema identified [Last Updated On: October 8th, 2012] [Originally Added On: October 8th, 2012]
- Probiotic found to reduce eczema symptoms over long-term period [Last Updated On: October 9th, 2012] [Originally Added On: October 9th, 2012]
- Now available: Naturally sourced eczema treatment for babies [Last Updated On: October 10th, 2012] [Originally Added On: October 10th, 2012]
- Research and Markets: Atopic Dermatitis (Eczema) - Pipeline Review, H2 2012 [Last Updated On: October 12th, 2012] [Originally Added On: October 12th, 2012]
- Stopping the itch: New clues into how to treat eczema [Last Updated On: October 12th, 2012] [Originally Added On: October 12th, 2012]
- Scratching does make itch worse [Last Updated On: October 12th, 2012] [Originally Added On: October 12th, 2012]
- Eczema Treatments for Men, Women and Infants Published by Medical Researcher [Last Updated On: October 13th, 2012] [Originally Added On: October 13th, 2012]
- Winterize Your Skin: 5 Essential Skin Care Tips for Eczema Sufferers [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- "Good bacteria" during pregnancy may ward off eczema: study [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- "Good bacteria" during pregnancy may ward off eczema [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Probiotics May Help Fight the Growing Eczema Epidemic [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Jack, Age Thirteen, Once Hospitalized for “Incurable” Eczema, Finally Finds Cure [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Likewise Skincare Releases Statement as Eczema Awareness Month Comes to Close [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Babies Cradle Amber Teething Necklaces - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Turmeric/Olive Oil mask for Hyperpigmentation/Eczema Scars - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Eczema Remedies 2 - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Eczema Cure Natural Way - Eczema Cure Natural Remedies - Download Ebooks - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Beat Eczema Review - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Naticura Products - Shea Nut Butter - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- HOW TO CURE ECZEMA NATURALLY #6 - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Eczema Remedies - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Wow New Seacret Product 602-793-0701 - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Making 5 Flower Tea for Reena's Eczema - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Tiny LUSH Haul..Reena's Eczema Treatment [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Bad eczema advice needed - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Mysterious Symptoms of Morgellons Disease - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- New Hepatitis C Treatment - Week 1: First Interferon Shot - Video [Last Updated On: October 31st, 2012] [Originally Added On: October 31st, 2012]
- Probiotics in pregnancy may prevent baby's eczema [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Effective Eczema Cure - Get Rid Of Eczema Treatment - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Mayday - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema Remedie... - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema Remedies 4 - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema Wet Dressing Instructional Video by Allerchic - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- New Hepatitis C Treatment - Week 1: First Dose of INCIVEK - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema Treatment In ElectroHomoepathy - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Stop suffering from dry skin and Eczema - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Eczema Diet Secrets | Natural Eczema Treatment - Video [Last Updated On: November 2nd, 2012] [Originally Added On: November 2nd, 2012]
- Journey toward Wholeness Dry Skin - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- New Hepatitis C Treatment - Week 2: INTERFERON INJECTION - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- October Favorites 2012 - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Arthritis, Fibromyalgia, Infections, Acne, Bunion, etc. - 5000Hz Isochronic Tones - Pure Series - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Vanish Eczema! - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Treating Skin Eczema Guide - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Deafness, Eczema, Epilepsy, Gallstones, Gingivitis, etc. - 20Hz Isochronic Tones - Pure Series - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Forever Living Products for Animals - Video [Last Updated On: November 4th, 2012] [Originally Added On: November 4th, 2012]
- Eczema made my childhood a misery. I'm so devastated I've passed it on to my son [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]
- Baby learns to beatbox - Video [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]
- Slender! (10/22/2012) #61 - Video [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]
- Top 3 Best Eczema Treatment Guides Online - Video [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]
- iWANT to see Grandma El's products in Target stores! - Video [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]
- Harley Wrap - Discovery Channel Feature - Video [Last Updated On: November 7th, 2012] [Originally Added On: November 7th, 2012]