What is Atopic Dermatitis;

 Atopic dermatitis or eczema is an itchy, dry, hypersensitive skin disorder affecting many people. It is common in children but can occur at any age. It is not infectious or contagious. 

The exact cause of atopic eczema is unknown. It may be hereditary. The patient or some family members may have other hypersensitive conditions like asthma or hay fever.

The rash may appear red, wet and weepy or dry, thickened and scaly. Scratching often aggravates the rash. The skin thickens and becomes darker. It is a chronic condition. It can affect any part of the body, particularly the elbow bends, back of the knees and the neck.

Question and Answers :

Since atopic dermatitis is sometimes associated with food allergies, can the elimination of certain foods be of help?
Yes, but it is uncommon. Although certain foods will sometime provoke attacks, especially in infants and young children, elimination of foods rarely brings about a lasting improvement or cure.

Nevertheless, when all else fails, avoidance of common offending foods such as cow's milk and eggs, may be tried for a few weeks.

Are the inhaled and contacted substances in the environment important causes, and should they be eliminated ?
Yes. Dust and dust-forming objects (for example, feather pillows, kapok pillows and mattresses, dust-forming carpet, drapes, toys and certain rough garments such as wool, coarse silk) worsen the rash. Try to wet mop or vacuum floors, rather than sweep. Reduce contact with animal furs.
Are skin tests, as done in patients with hay fever or asthma, of value in finding the offending substances ?

Yes, at times. However, results can be misleading particularly when the tests are carried out by persons inexperienced with such tests.

What should be done to treat atopic dermatitis ?
See your dermatologist. Try to relieve itching by eliminating these aggravating factors:

Rapid changes of temperatures, strenuous exercise and hot weather.
Rough, tight & woollen clothing.
Frequent use of soaps, bubble bath, hot water, and other cleansing procedures that tend to remove natural oil from the skin. Use mild detergents for your clothes and rinse the clothes thoroughly during washing.
Emotional upsets.
It is important to comply with treatment. Your dermatologist can usually help you by prescribing external remedies (corticosteroid creams are most effective). Use the creams sparingly. Do not use strong steroid creams for long periods as over-use will harm the skin. Use weak steroid creams when your eczema is mild. Oral medication (sedatives, antihistamines and sometimes, antibiotics by mouth) to control the itching and baths with diluted potassium permanganate are helpful.

Corticosteroids taken by mouth or given by injections should be avoided if possible. However, when all other measures have failed, your physician may prescribe systemic corticosteroids for short periods.

Generally 90% of children outgrow the condition by early teens, although some continue to have problems even as adults.

Are there any other problems ? 

Bacterial infection (pus) and viral infection (eg. herpes simplex) can occur. Antibiotics and antiviral treatment are needed. 

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