Atopic Dermatitis
Also known as atopic ECZEMA, this is a common condition in infants, often appearing between two and 18 months of age. It tends to occur in those with an inherited tendency to develop allergy and is found in 10 percent of the population. The condition is usually associated with ASTHMA, HAY FEVER, or ALLERGIC RHINITIS, and it may affect as many as seven to 24 of every 1,000 people. It is most common in children.
Typically, the condition begins in the first year of life, fading away about 40 percent of the time by age 15. However, children with very severe disease are more likely to have persistent problems as they get older. Although there is no cure, the long-term prognosis is good.
Symptoms
In acute cases, this form of eczema is characterized by a mild, very itchy rash on the face, inner elbow creases, and behind the knees, with red, scaling skin and pimples. If scratched, the pimples leak a clear liquid, forming large weeping areas; infection may occur if the condition appears in the diaper area.
Atopic dermatitis tends to wax and wane. In chronic cases there are scaling and skin color changes. Most children improve during the summer and worsen during the winter, which is probably related to humidity and temperature.
Treatment
Keeping adequate hydration of the skin and avoiding irritants may be all that is required of children with mild cases. Irritants include wool clothing, strong detergents, and water. Irritants can be avoided by using a mild detergent (such as Ivory Snow flakes or Dreft), by avoiding wool, and by adding bath oil to bath water. Emollients such as white petrolatum should be applied immediately after bathing, and topical corticosteroids and tar preparations are useful. Oatmeal (Aveeno) baths are helpful, as is daily moisturizing with emollients such as Eucerin cream.
In acute cases, a medium-potency topical corticosteroid lotion or cream should be applied after bathing or after applying aluminum acetate or saline compresses. For chronic cases, potent topical corticosteroids should be applied right after bathing; soaking or using compresses of watersoluble tar preparations may decrease the need for topical steroids. However, the risks of these drugs limit their use in long-term treatment.
Adequate doses of antihistamines can control itching and prevent scratching, which could lead to secondary infection; oral antibiotics are helpful if infection develops, which is a frequent complication in itchy children.
Posted in Health and Wellness
