ATOPIC DERMATITIS (ECZEMA)

WHAT IS ATOPIC DERMATITIS (ECZEMA)?

Atopic dermatitis is a long-term skin disorder characterized by itching, inflammation, and scaling. It is most common in infants and at that age is most frequently seen on the face and cheeks. Fortunately, most atopic dermatitis in infants clears up by the time the child is 18 months old. Children with persistent atopic dermatitis most frequently have flat, red itchy areas in the creases of their elbows and wrists as well as behind their ears and knees, though it can occur in other locations. Atopic dermatitis also occurs in adults, generally as a chronic or reoccurring condition. There is often a family history of hay fever, psoriasis, asthma, or another allergy-related disorder.

Neurodermatitis (also called scratch dermatitis) is a type of atopic dermatitis that involves the scratch-itch cycle: an itch causes scratching behavior, increasing itchiness, leading to more itching and more scratching. Lichen simplex chronicus is the localized form of neurodermatitis in which chronic scratching leads to thickening of the skin and for the skin to develop a leathery texture. Neurodermatitis can be triggered by something that irritates the skin or by eczema, psoriasis, stress, or anxiety.

ATOPIC DERMATITIS SYMPTOMS

Blisters (with possible oozing, crusting, redness, and/or inflammation)
Dry skin
Ear discharge or bleeding
Inconsistent skin pigmentation
Intense itching
Leathery skin
Rash
Raw skin

ATOPIC DERMATITIS DIAGNOSIS

Dr. T diagnoses atopic dermatitis by examining the affected skin and reviewing your family and medical history. He may also use patch testing or other tests to rule out other skin diseases or identify conditions that accompany your eczema such as allergies. Allergies and atopic dermatitis are closely associated, known as the atopic march.

The atopic march suggests that patients who experience eczema as an infant have a greater chance of developing allergies, specifically food allergies, and asthma as children and adults. Because of this risk of developing a food allergy, it is critical to see an allergist for allergy testing as early as possible. When a child’s eczema is under good control, their skin is better at preventing food allergens from getting in.

ATOPIC DERMATITIS TREATMENT

There are many different treatment plans for atopic dermatitis and may vary from person to person. Recognizing the symptoms early is your best chance for fast relief. Regular moisturizing should be apart of every treatment plan for skin disorders like eczema. Your allergist may also recommend medications that control itching and help repair the skin. These include corticosteroid creams or ointments. However, it is important to note that the overuse of these drugs may cause side effects such as thinning skin.

Doctors also prescribe other creams containing drugs called calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel) to help control skin reactions. These drugs have a black box warning about a potential risk of cancer. However, the American Academy of Allergy, Asthma & Immunology has concluded that existing data doesn’t support the use of the black box warning.

Treatment for atopic dermatitis may also include drugs to fight infection. Your allergist may prescribe an antibiotic cream or oral antibiotics if your skin has a bacterial infection, an open sore, or cracks due to scratching. He or she may recommend taking oral antibiotics for a short time to treat an infection.

For more severe cases, you may need prescribed oral corticosteroids, such as prednisone. These drugs are effective but should not be used long term because of potentially serious side effects. The Food and Drug Administration (FDA) has recently approved a new, injectable biologic called Dupixent. It is used to treat people with moderate-to-severe eczema.

SUMMARY

If you are concerned about atopic dermatitis or eczema, Dr. Tamayev would like to help. Dr. T will perform necessary testing and work with you to reach an accurate diagnosis. Dr. T will also develop a treatment plan to alleviate your symptoms and help you get back to normal. Schedule an appointment today by using the button below!