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Atopic Dermatitis

Don't Ignore the Itch, It Could Be a Signal of Rash!

Eczemas are skin conditions that present with dry, itchy, and rough patches of skin on the face, elbows, behind the knees, and on the hands and feet of an individual. Atopic dermatitis (AD) is the most common form of eczema but most people typically refer to it as eczema.

Atopic dermatitis is a chronic (long-term) skin disease that can cause inflammation, redness, and a rash. It is not contagious (cannot be spread from person to person) and can occur again (relapse) if proper care is not taken. Usually seen in infancy and in childhood, atopic dermatitis can also occur in adults. Atopic dermatitis affects 2.4% of the population globally with children till the age of 10 being most susceptible to it.

Studies have shown that AD is most commonly seen in more socio-economically developed nations in comparison to nations with low socioeconomic status.

For understanding the symptoms, causes, and treatment of atopic dermatitis, consult, Dr Samatha the best dermatologist at Samatha Skin Clinic and Wellness Centre, Hyderabad.

Causes of AD

There are many theories that revolve around the causes of AD. It is believed that AD may be caused due to:

  1. Defect in the skin barrier due to a mutation in the genes- Our normal healthy skin barrier protects our body from bacteria and allergens while retaining moisture. In AD, there is a mutation in a gene that disrupts the skin barrier, allowing allergens and other irritants to rob the moisture from our skin. This leads to dryness of the skin and the development of rashes, culminating in AD.
  2. Family history of developing AD.
  3. Overactive immune system-due to exposure to external irritants/factors like smoke, chemicals, fragranced skin products, etc., our immune system gets triggered and becomes overactive. This makes our skin dry and predisposed to develop a rash and finally, AD sets in.

Risk Factors

The risk factors for the development of AD are higher in children if there is a family history of eczema, asthma, hay fever (allergic reactions to pollen, dust, or any other environmental factor), or any other allergies.

Symptoms

Itching is the most common symptom of atopic dermatitis, which can range from mild to severe. Itching may occur before the appearance of the rash. Symptoms of eczema may differ from person to person and may also appear in different areas for different individuals. The other skin symptoms in an AD person will be:

  1. Drying of skin
  2. The appearance of red patches on the skin
  3. Thickening of skin
  4. Blistering of the skin
  5. Oozing of blood, clear fluid from the skin on scratching

These symptoms vary depending on the age of the individual

Eczemas are skin conditions that present with dry, itchy, and rough patches of skin on the face, elbows, behind the knees, and on the hands and feet of an individual. Atopic dermatitis (AD) is the most common form of eczema but most people typically refer to it as eczema.

In infants and children < 2 years of age

The itchy, red rash appears mainly on the face, scalp and at the area of joint bends. The rash may also extend to the arms, legs and chest and oozes when scratched. Atopic dermatitis does not involve the diaper area of infants.

In children (> 2yrs) and teenagers

In children, the appearance of the red rash causes a thickening of the skin and may ooze blood when scratched. In later stages, the rash becomes scaly and crusting develops. It is most commonly seen on bends of the elbows, behind the knees, on the neck, on the wrists and ankles.

In adults

The skin with atopic dermatitis in adults and some teenagers appear dry, thick, and scaly with the presence of a rash on the backs of the knees, wrists, hands, and feet. These skin changes may start as a reddish patch and later turn brown in a fair skin individual. In darker-skinned individuals, the affected area becomes lighter or darker due to AD.

Other places on the body where the skin is affected by AD

  1. Eyes-darkening of skin under the eyes; development of the extra layer/fold of skin under the eyes.
  2. Palms and soles of the feet- Appearance of extra skin creases.

Conditions associated with Atopic Dermatitis

Atopic dermatitis just does not come with a specific set of skin problems but also carries a significant emotional burden with itself. People with atopic dermatitis are found to have low, self-esteem, and decreased quality of life with sleep disturbances. Other conditions associated with AD are asthma, food allergies,slin conditions like ichthyosis (dry, thick skin), anxiety and depression. It is believed that stress aggravates AD and leads to the worsening of the disease.

Diagnosis of Atopic Dermatitis

At Dr. Samatha Clinic, Hyderabad, experienced dermatologists diagnose atopic dermatitis by history and physical examination. A patch test is sometimes done to diagnose the condition that identifies the allergen which has triggered AD. In this test, an allergen is applied to the skin and if that allergen is the trigger, the skin will get red, inflamed and would start to itch. The dermatologist would sometimes take a blood sample or a skin biopsy to rule out other causes of weeping or oozing dermatitis.

Management of Atopic Dermatitis

There is yet no cure for eczema, hence the treatment focusses on reducing symptoms, healing the skin, and preventing further flare-ups.

Light therapy

Also known as phototherapy, it is the modality of treatment that can be tried if oral or topical creams are not effective. In light therapy, the skin is exposed to controlled doses of natural sunlight. The light sources used are artificial ultraviolet A (UVA) and narrowband ultraviolet B (UVB) alone or in combination with other medications. Light therapy can be tried only after consultation with your dermatologist. Consultation for light therapy in AD can be taken from Dr. Samatha, the best dermatologist at Dr. Samatha Clinic, Hyderabad. In infants and children, light therapy is not advised as it may predispose them to the risk of developing skin cancers.

Complications of Atopic Dermatitis

AD may lead to some complications that may sometimes be a cause for concern.

  1. Skin infections- In atopic dermatitis, continuous scratching of the skin would result in open wounds and cracks on the skin. Due to this, bacterial viral infections, especially Herpes simplex virus (HSV) infections can penetrate the wounds and lead to skin infections.
  2. Permanent Thick and Leathery skin- Continuous scratching of the skin in a particular area for a long time leads to the skin becoming discoloured, thick and leathery hard- a condition known as neurodermatitis.
  3. Sleeping disturbances- Continuous itching causes an alteration in the sleep cycle and leads to waking up multiple times in the night. This results in daytime sleeping and disruption of daily routine making one fatigued throughout the day.
  4. Chronic hand eczema- Individuals working with cosmetics like beauticians, make-up artists, and in laundry services, if have AD, have the probability of developing hand eczema. This is due to their use of harsh chemicals on their hands throughout the day.
  5. Asthma and allergies- Studies have shown that by the age of 13, more than half of the children with atopic dermatitis develop asthma and hay fever.

When to visit your doctor?

It is advisable to visit your dermatologist if the symptoms flare up. Take an appointment with Dr. Samatha, the best dermatologist at Dr. Samatha Clinic, Hyderabad, if:

  1. Your symptoms are not responding to medicines and have aggravated
  2. You are having continuous itching
  3. You are unable to sleep at night due to your symptoms
  4. There is blood or fluid oozing out of the wounds
  5. Skin is becoming flaky, thick, or scaly

Even though there is no cure for atopic dermatitis, the symptoms can be controlled and prevented by seeking medical help. It is important to consult your doctor to get a proper treatment plan and advice.

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