Eczema – Atopic Dermatitis. Causes, Symptoms, and Treament

Atopic dermatitis is a chronic inflammatory skin disease. A condition that results in itchy rashes on the flesh.

What do you need to know about Atopic Dermatitis?

Atopic dermatitis is the most common type of eczema. It is a long-lasting skin disease and a particular allergic reaction that includes asthma or hay fever.

Also, this skin disease affects people of any age, but mostly it affects the infants and young children.

Atopic dermatitis, also called eczema, is the name of a chronic eruption that affects certain people with sensitive skin.

Under the name of eczema or dermatitis, all skin lesions that cause itch are included and are red, scaly and exudative.

Examples of eczema include various types of skin diseases among which are dermatitis, allergic to multiple substances such as metal, cosmetics, gloves, etc.

Also, eczema seborrheic eczemas that appear in the greasier areas of the face and Atopic eczema atopic eczema that is explained in this article is a different disease than the previous ones and can be called eczema, constitutional eczema or atopic dermatitis.

People when having this disease experience itchiness and inflamed tissue that result in redness, cracking, scaling, crusting and swelling on the infected part of the skin.

Most often, this skin disease affects the face, hands, inner elbows, and feet and back of the knees.

What causes eczema, atopic dermatitis?

Though the atopic dermatitis is the most common type of skin disease, the cause of it is still unknown, but, experts believe that it comes from the combination of genetic and environmental factors.

On the other hand, any factors can activate the skin disease at any time, especially those who inherit the disease. According to research, people having atopic dermatitis have a weak immune system.

How will you know that you have atopic dermatitis?

Dry, itchy, red skin are the most common symptoms of atopic dermatitis. Though, the symptoms may vary with every person.

Such, cracks behind the ears and rashes on other parts of the body are other symptoms of atopic dermatitis that are not usual for many patients. Itching is the trademark of this disease.

On the other hand, the itchiness of the infected part is very important for the patient to need to watch for.

Itchiness can lead to scratching and rubbing that can get the skin inflammation worse.

Moreover, some things can irritate the infected area and can make worse the symptoms of atopic dermatitis.

People presenting the symptoms of this skin disease should avoid direct contact with soaps, household chemicals, rough clothing and other allergy triggers.

Similarly, people who have atopic dermatitis are more sensitive to itching and mostly feel the need to scratch the area. Many patients notice that itchiness gets worse in the early evening.

Furthermore, atopic dermatitis is not contagious. It can’t be passed from one person to another. A person can’t acquire atopic dermatitis from an active patient, but they have an active skin disease.

People that have atopic dermatitis have a weak immune system, and they are also prone to have other skin infections.

Thus, some patients get secondary infections that carry bacteria to other fungal infections.

This is the reason why other people used to think that they acquired atopic dermatitis from the infected person, where in fact, they just got the secondary disease.

Atopic dermatitis is due to a reaction (similar to an allergy) on the skin. Such reaction causes continuous swelling and redness.

People with atopic dermatitis may be more sensitive because their skin lacks specific proteins.

Atopic dermatitis is more common in babies. It can start even at the age of 2 to 6 months. Many people outgrow it over time early in adulthood.

People with atopic dermatitis often have asthma or seasonal allergies. Usually, there is a family history of allergic conditions such as asthma, allergic rhinitis or eczema.

People with atopic dermatitis are often positive in skin tests for allergies. But this dermatitis is not caused by allergies.

Causes

100% of the causes of atopic dermatitis are unknown. Even so, many factors can trigger a neurodermatitis. The hereditary factor is likely to play a significant role.

Atopic dermatitis usually affects 75% of the two twins, if they are monozygotic (that is, they come from a single ovule) and if the two babies are twins, only in 23% of the cases will both be affected by the pathology.

If both parents have atopic dermatitis, children will have a 60 to 80% chance of suffering from the disease.

The trigger of inflammation in the skin, characteristic of atopic dermatitis, is the reaction of the body’s immune system to harmless substances such as certain foods, dust or pollens.

These substances are called allergens. In atopic dermatitis, some white blood cells, lymphocytes, which are designed to attack harmful substances, react to these allergens.

Therefore, the body (more specifically antibodies) responds by fighting back against these harmless allergens.

One of these antibodies to immunoglobulin E (IgE). Together with other transmitting substances of the immune system, the cytokines, the IgE initiates the inflammation reaction in the skin.

Cytokines are the part of the immune system that directs the fight against the causes of the disease.

Different white blood cells, mainly the T lymphocytes, maintain the inflammatory reaction.

In addition, the body secretes another substance, histamine, which promotes more inflammation. This situation increases the immunological response of the organism and causes the typical itching of this skin disease.

The timing and intensity of an outbreak of atopic dermatitis are determined by a stimulus caused by certain agents, such as:

Various allergens such as pollen or dust mites
Mechanical stimuli of the skin (contact with wool or sweat perspiration)
Certain foods such as nuts, milk, and wheat
Infections
Weather conditions, such as extreme cold or heat

Psychic stress, which can also appear in children, can worsen atopic dermatitis. In each particular case, the disease is associated with different triggers.

Symptoms of atopic dermatitis:

Allergies to pollen, mold, dust mites and animals.
Colds and dry air during the winter.
Colds or the flu.
Contact with irritating and chemical materials.
Contact with rough materials such as wool.
Dry skin.
Emotional stress.
Dry skin due to frequent baths.
Overcooling or overheating, as well as sudden changes in temperature.
Perfumes added to lotions or skin soaps.

The symptoms of atopic dermatitis appear, above all, on the skin. This appears drier and dehydrated than normal skin and accumulates moisture worse.

In fact, the skin loses part of the layer of fat that protects it. Because of this deficit, the flesh appears rough and flakes easily and does not perform well its protective mission.

Also, the production of sweat, the irrigation of the skin and the regulation of body temperature are all altered.

Our environment, as well as our skin, is colonized by a wide variety of bacteria and fungi. In patients with atopic dermatitis, the composition of these colonizers varies, which can worsen the symptoms.

The severity of the symptoms of atopic dermatitis is not synonymous with the real damage that this skin disease can cause the patient.

And, in particular cases, mild symptoms can significantly affect the patient and even cause psychological affectation.

This can reduce school or work performance, lead to difficulties in the social environment and also trigger depression.

Tests and exams.

The doctor will look at the skin and perform a physical exam. A skin biopsy may be needed to confirm the diagnosis or rule out other causes of dry, itchy skin.

Diagnosis

The diagnosis of atopic dermatitis is made with the clinical history (anamnesis) and physical examination.

Usually, thanks to the anamnesis, many clues are obtained about an allergy or the presence of this disease in other members of the family.

In the physical examination, the anatomic location of the lesion will guide us on whether it is atopic dermatitis or not.

There are injuries that are very frequent in atopic eczema and help to make a medical diagnosis.

The marked lines of the palms of the hands (ichthyosis), a double fold in the eyelid (Dennie-Morgan’s fold) or dark circles in the lower eyelid of the eye are essential to diagnose atopic dermatitis.

Also, blood tests and skin tests can be performed that will help us determine the sensitivity of the patient to certain substances.

Skin tests

These help determine if the body reacts with an exaggerated immune reaction to different stimuli. This is the case in atopic dermatitis.

Substances that are usually tested are usually pollens, dust mites, food or animal epithelium.

These tests consist in putting the allergen in contact with the organism through small lesions that are made on the skin.

The allergens are diluted in liquid (prick test) or stick to the surface of the body. These tests provide results after minutes or days.

Blood test

In these tests the levels of immunoglobulins, responsible for inflammation of the skin, are determined.

Typically, allergies and atopic dermatitis are elevated. In a next step, even the allergen against which the IgE is directed can be identified.

What are the treatments for atopic dermatitis?

There are many treatments for this kind of skin disease. People who have atopic dermatitis have dry and itchy skin. Thus, using products to moisturize the skin could be a great help as well as the use of ointments and steroid creams.

Moreover, people who have this skin disease tend to have a weak immune system and taking drugs to help control the immune system is a great help in order not to acquire other diseases.

Taking antibiotics is more important as well, in order not to get other skin infections.

Expectations (prognosis)

Atopic dermatitis lasts a long time. People can control it with treatment, avoiding irritants and keeping the skin well moisturized.

In children, this condition often begins to disappear around 5 to 6 years old, but often exacerbations occur. In adults, the problem is usually a prolonged or recurrent condition.

Atopic dermatitis may be more difficult to control if:

It starts at an early age.
It compromises a large part of the body.
It occurs along with asthma and allergies.
It occurs in someone with a family history of eczema.

Possible Complications

Some complications of atopic dermatitis that may occur are:

Infections of the skin caused by bacteria, fungi or viruses.
Permanent scars.
Side effects of prolonged use of medications to control eczema.

Evolution

The evolution of atopic dermatitis is very variable and depends on each specific case.

This disease appears already in childhood and may have an appearance of outbreaks that can vary in duration and intensity.

This skin disease can be cured at any time of evolution spontaneously. But 30% of children with atopic dermatitis will suffer it, too, in adulthood.

To what extent atopic dermatitis can affect the quality of life does not necessarily depend on the severity of the evolution since mild dermatitis can severely affect patients both physically and psychically.

In some cases, it can even negatively impact social life and produce depression.

Through an early and intensive treatment, the evolution of atopic dermatitis can be influenced, considerably improving the quality of life of patients.

Prevention

Children who are breastfed up to 4 months of age may be less likely to suffer from atopic dermatitis.

If the child is not breastfed, the use of a formula containing processed cow’s milk protein (called partially hydrolyzed formula) may decrease the chances of developing atopic dermatitis.