Atopic dermatitis

Atopic dermatitis (Atopic eczema) is a chronic non-infectious disease which is a part of the group of allergic diseases called ATOPY (Hay fever, Asthma, Atopic dermatitis).

Who suffers from Atopic dermatitis?

The disease is known for its early onset (after 3rd month) and is usually present in childhood, but also can be seen in the elderly. People living in big cities and in areas with dry climate are at a higher risk for developing Atopic dermatitis.

What causes Atopic dermatitis?

The mechanism is unknown. It is described as a combination of genetic factors (mutations, inheritance), immunologic disturbances and external triggers. Individuals with atopic dermatitis have a higher risk for suffering from hay fever and asthma.

How is Atopic dermatitis diagnosed?

The diagnosis is based on clinical symptoms. Every patient is unique and develops a combination of symptoms, which can change over time.

The main symptoms are:

  • General dryness of the skin
  • Red, scaling spots on the face, arms and legs, palms and feet and occasionally involving the whole body.
  • The involved skin is red, swollen and itchy. In more severe cases it is covered with crusts.
  • Over time the affected skin becomes rough and darkened.

During the medical examination the doctor should be informed about: Onset, type and evolution of the symptoms; factors that exaggerate the disease; other members of the family with the same symptoms or allergic conditions; concomitant diseases such as asthma or hay fever ; sleep disturbances; food or drinks that can worsen symptoms; previous treatment of dermatological diseases; previous use of corticosteroids for treatment. For confirmation of the diagnosis it might be furthermore required to examine biopsy samples and to perform an allergy test.

Which factors aggravate Atopic dermatitis?

Irritating substances and allergens can worsen the condition. Irritants are materials which, in contact with the skin, lead to irritation and itching. For example: wool, soaps, cleansing detergents, make-up, chloride substances, mineral oils, solvents, home dust, sand, cigarette smoke etc. Allergens are substances found in some food, plants, animals, air etc. For instance: eggs, apples, milk, fish, soya, grains, molds, pollens, fur, pets etc. Emotional status such as stress, irritation, anger can worsen atopic dermatitis but is not the main cause. Skin infections, fever and climate changes also influence the disease. Other factors which can aggravate atopic dermatitis are: sporadic use of emollients, low humidity, heating body procedures (hot bath, soaps, steam showers etc.) rapid temperature changes and bacterial infections.

What is the treatment of Atopic dermatitis?

The goal of the treatment is to suppress the excessive phase of the disease and to prevent exacerbation. For better results the treatment should be carried out not only by the doctor but also by the patient and his family, as well. The therapeutic plan is individually based and depends on: age, clinical symptoms and health status of the patient. It is also necessary to strictly follow the prescriptions and record any medications which didn`t bring benefit for the condition. Usually application of medical cosmetic creams and lifestyle changes improve the condition.

The prescription of your doctor will help you to:

  • choose the appropriate hygiene products for your skin
  • avoid external factors which worsen the disease
  • manage acute phases of the disease

The main products which are used in treating atopic dermatitis are:

  • creams or ointments which control sweat, reduce allergic reactions and restore the skin barrier
  • topical application of corticosteroids or calcineurin inhibitors
  • antimicrobial drugs or creams
  • antihistamines

When this treatment does not work the doctor can decide to add phototherapy, photo-chemotherapy or systemic immune modulators (Corticosteroids, Cyclosporine, Methotrexate etc.)

Over the last years a new group of drugs has been established for treating chronic skin disorders. This group is called biologicals. Their mechanism is based on blockage of specific signals and molecules in the immune pathogenesis of the disease. Up to now there are more than 10 different types of biologicals that show promising therapeutic results.