Atopic dermatitis (AD)
1. What is Atopic dermatitis?
It consists of severely itchy, skin rash generally seen in young children & adolescents, which may be recurrent or may last for longtime.
It is a common disease in developed countries, around 10-20% children suffer from AD. In India, exact prevalence is not known, but it is supposed to be low.
2. What are the factors causing Atopic Dermatitis?
A. Genetic: AD is more likely to develop if one or more parents have the disease or history of allergic tendencies (Atopy)
• Excessive cold climate
• Heat and exercise induced sweating
C. Altered Immunity: alterations in immune system (protective system which fights with disease pathogens) has been given as major factor
D. Defective barrier function of skin leading to excessive loss of water ?
E. Dietary factors
3. Which diseases are associated with it?
It is commonly associated with other allergic diseases like,
• Hay fever
4. What are the Symptoms of AD?
• It generally starts between 2-6 months of age, but can manifest in any age group
• Children generally have dry scaly, itchy, red patches over face. Once child begins to crawl, these patches are seen over exposed parts of hands & legs
• In older children & adolescents, patches are mainly seen on inner aspect of hands and feet
• Many times there is
• discharge from patches due to presence of bacterial infection
• thickness of skin due to constant scratching /rubbing
1. Creams to be applied on pimples/affected area
2. Tablets mainly mild antibiotics , isotretinoin etc
3. Chemical peels
4. Lasers like IPL
5. What are the Factors worsening AD?
a. Woolen clothing
c. Excessive Heat & sweating
d. Skin irritants: perfumes, soaps
e. Habitual scratching
f. Dryness of skin
g. Skin infections
h. Food allergens- include cow''s milk, beef, eggs, chicken, fish, wheat, citrus & berry fruits, food additives, chocolates, nuts
i. Airborne allergens
6. What general care should be taken by for the patient of A.D.?
• Avoidance of worsening factors: It forms most important part of disease management. With time parents tend to recognize the triggers of disease flare & simply avoiding them can help a lot.
• Proper skin care which includes
I. Take bath with lukewarm water & mild skin cleanser
II. Air-dry or pat dry your body
III. Apply ample amount emollient cream all over body
IV. Early detection of fissures, scratches & oozing lesions
7. How A.D. can be treated?
a. Anti allergic/anti-itch tablets(Antihistamines) to decrease itching & irritation, especially sedative agents at night so that that child has sound sleep
b. Judicious use of low strength steroid creams for a short time. depending upon severity, sites & age of patients
c. Antibiotics in presence of oozing & discharge
d. Creams containing Calcineurin inhibitors
e. Phototherapy in the form of Narrow Band Ultraviolet B rays(NB-UVB) is very useful tool in control of extensive disease
f. In case of severe disease, certain oral medications (immunosuppressive agents) are also required