Atopic dermatitis

Also called eczema

This is a common skin disease in children. It is so common that people have given it a few names:

• Eczema (name most people use).
• Dermatitis.
• Atopic (a-top-ic) eczema.
• Atopic dermatitis.

To avoid confusion, we’ll use the medical term atopic dermatitis.

Children often get atopic dermatitis (AD) during their first year of life. If a child gets AD during this time, dry and scaly patches appear on the skin. These patches often appear on the scalp, forehead, and face. These patches are very common on the cheeks.

No matter where it appears, AD is often very itchy. Infants may rub their skin against bedding or carpeting to relieve the itch.

In children of all ages, the itch can be so intense that a child cannot sleep. Scratching can lead to a skin infection.

Because atopic dermatitis can be long lasting, it is important to learn how to take care of the skin. Treatment and good skin care can alleviate much of the discomfort.

Source: https://www.aad.org

Signs, symptoms

Atopic dermatitis (AD) looks different in infants, children, and adults. The following gives you the signs (what you see) and symptoms (what you feel) for each age group.

Infants

AD can begin early. A child may be 2 or 3 months old when AD begins. When AD begins early, it often causes:

• A rash that appears suddenly and:
  • makes the skin dry, scaly, and itchy.
  • forms on the scalp and face, especially on the cheeks (can appear on other areas of the body).
  • can bubble up, then ooze and weep fluid.
  • causes itching that may come and go.
• Rubbing against bedding, carpeting, and other things in order to scratch the itch.
• Trouble sleeping.
• Skin infections, common due to rubbing and scratching.

Parents often worry that their babies are getting AD in the diaper area. A babies rarely gets AD in his or her diaper area. The skin stays too moist for AD.

Children

When AD begins between 2 years of age and puberty, the child often has these signs and symptoms:

• A rash that often begins in the creases of the elbows or knees. Other common places for the rash to appear are the neck, wrists, ankles, and/or crease between the buttocks and legs.
• Itchy, scaly patches where the rash appeared.

In time, the skin with AD can:

• Get bumpy, looking like permanent goose bumps.
• Lighten (or darken) where AD appears.
• Thicken, turning leathery to protect itself from constant scratching.
• Develop knots (only on the thickened skin).
• Itch all the time (only on the thickened skin).

The thickened skin can itch even when the AD is not flaring.

When talking about the thickened skin, your dermatologist may use the word lichenification. This word means thickened skin.

Adults

It is rare for adults to get AD. Most people (90%) get AD before age 5. About half (50%) of people who get AD during childhood continue to have milder signs and symptoms of AD as an adult. When an adult has AD, it often looks different from the AD of childhood. For adults, AD often:

• Appears in the creases of the elbows or knees and nape of neck.
• Covers much of the body.
• Can be especially noticeable on the neck and face.
• Can be especially bad around the eyes.
• Causes very dry skin.
• Causes non-stop itch.
• Causes scaly skin — more scaly than in infants and children.
• Leads to skin infections.

If a person has had AD for years, patches of skin may be thick and darker than the rest of the skin (or lighter). Thickened skin can itch all the time.

Adults who had AD as a child and no longer have AD can have the following:

• Extremely dry skin.
• Skin that is easily irritated.
• Hand eczema.
• Eye problems (eczema on eyelids, cataracts).

Source: https://www.aad.org

Who get, causes

Who gets atopic dermatitis?

Around the world, between 10% and 20% of children have AD. About 1% to 3% of adults have AD. People of all skin colors get AD.

Most people (90%) get AD before their 5th birthday. AD rarely starts when a person is an adult.

AD is much more common today than it was 30 years ago. Dermatologists are not sure why. They do know that some children have a greater risk of getting AD. The following seem to increase a child’s risk of getting AD:

• Family members have AD, asthma, or hay fever: Does the child’s mother or father have AD? Does a parent have asthma or hay fever? A family history of these diseases remains the strongest risk factor. If one or both parents have AD or an allergic condition, the child is much more likely to get AD. Some children get all 3 diseases. Asthma and hay fever usually appear before the age of 30. People often have asthma and hay fever for life.
• Where child lives: Living in a developed country, city (especially one with higher levels of pollution), or a cold climate seems to increase the risk. For example, Jamaican children living in London are twice as likely to develop AD as those who live in Jamaica.
• Gender: Females are slightly more likely than males to get AD.
• Mother’s age when child born: When the mother gives birth to the child later in her childbearing years, a child is more likely to get AD.
• Social class: AD seems more common in higher social classes.

What causes atopic dermatitis?

Researchers are still studying what causes AD. Through their studies, they have learned that AD:

• Is not contagious: There is no need to worry about catching it or giving it to someone.
• Runs in families: People who get AD usually have family members who have AD, asthma, or hay fever. This means that genes play a role in causing AD.
  • Children are more likely to develop AD if one or both parents have AD, asthma, or hay fever.
  • About half (50%) of the people with severe AD (covers a large area of the body or is very troublesome) will get asthma and about two-thirds (66%) will get hay fever.

Can certain foods cause atopic dermatitis?

Foods do not cause AD. But some studies suggest that food allergies can make AD worse. Children who have AD often have food allergies to these foods — milk and foods that contain milk (e.g., yogurt and cheese), nuts, and shellfish.

Before you stop feeding your child any foods, talk about this with your child’s dermatologist. Children need certain foods to grow and develop normally.

Researchers continue to study what causes this complex disease. They believe that many things interact to cause AD. These things include our genes, where we live, and the way our immune system works.

Source: https://www.aad.org