Atopic Dermatitis


atopic eczema

What is it?

Atopic dermatitis is a chronic disease causing skin inflammation, leading to the development of lesions and pruritus. About 30% of the individuals with atopic dermatitis have asthma or allergic rhinitis, and 15% have urticaria fits. Some studies point out that 70% of the patients have a family history of atopia (asthma, allergic rhinitis or atopic dermatitis)

How is it acquired?

An individual with atopic dermatitis presents an increased cutaneous reactivity in the presence of a number of stimuli. The mechanisms responsible for this altered reactivity are not fully known. What is known is that genetic, immulogical and non-immunological factors contribute to the development of the condition.

Main triggers:

Foods: milk, eggs, wheat, soy, peanuts, fish and seafood.
Environment factors: mites/arachnids, fungi, animals and pollen
cutaneous irritants: wool, soap, detergents, fabric softener, solvents and sweat
Infections: viruses and bacteria.
Emotional Factors.

What does One Feel?

Individuals typically experience intense pruritus. The most frequent lesions are: erythema (redness); edema (swelling); exudation (skin secretion); scab and scaling; dry skin and white patches (pityriasis alba). Flexural lesions are most frequent, such as wrists, forearms and hinder part of the legs.

How does the Doctor Make the Diagnosis?

The diagnosis is clinical on the basis of the manifestations that represent the criteria considered absolute and the so-called minor criteria.

Absolute Criteria:

Pruritus (itching): is a constant manifestation in atopic dermatitis throughout its stages. Morpho-topography: typical sites of atopic dermatitis. In infants, facial aspects with acute lesions. During the prepubertal phase (2-12 years old), the lesions are subacute, preferentially in the elbow folds, behind the knees, neck, hands and feet. During the adult phase (over 12 years old), the lesions are chronic with acute fits in various sites. Tendency for chronicity and/or frequent recurrences.

Minor criteria:

Personal or family history of atopic manifestations
testing positively for immediate cutaneous tests
White dermographism or prolonged vasoconstriction
Low back pain

How is it treated?

Because no definitive cure has yet been found, the purpose of the treatment should be the control of the condition, while in the meantime awaiting a possible spontaneous remission of the dermatosis. This way, the treatment should be oriented towards lessening the symptomatology and inflammatory reactivity, recognizing, removing or excluding the factors that worsen the condition.

Cutaneous hydration is key to the treatment. Topical anti-inflammatory drugs (corticosteroid cream or ointments) can be used, as well as antihistaminic, orally, in order to control the pruritus and lessen skin eruptions. Immunomodulators and immunosuppressors are also indicated to aid in the treatment.

How is it Prevented?

There is no prevention mechanism, but atopic dermatitis may be controlled through caution in terms of avoiding the factors that may trigger the condition.