Atopic dermatitis is a non-infectious chronic disease where the skin of the face and body is constantly dry, red and irritated. Most commonly this condition affects babies and young children. In 90% of patients, the first symptoms appear before the age of 5 years. The course of atopic dermatitis is variable – with periods of exacerbation and attenuation.
The exact cause is not known, but it is most likely a combination of dry, irritated skin with impaired immune system function. Stress and other emotional factors can aggravate the condition of atopic dermatitis, but they cannot provoke it. There are a number of theories that try to clarify the reason for its occurrence:
Genetic predisposition – in patients with atopic dermatitis there are immunological defects and incomplete fat formation in the surface layer of the skin, resulting in its dryness and ineffective hydration. If the patient has a parent with atopic dermatitis, the risk of developing skin symptoms increases
Infection – the skin of patients with atopic dermatitis is very often colonized with a Staphylococcus aureus bacterium that is capable of causing an infection exhibiting the characteristics of atopic dermatitis.
Climate – Low humidity, high temperatures, and cold deepen the dryness of the skin and affect poorly the condition of patients with atopic dermatitis
Air allergens – house dust and mites are supposed to be a possible reason for the occurrence of atopic dermatitis but this in not yet proven.
In infants, the first rashes are on cheeks and scalp. There are tight-fitting crusts on the hairy zone of the head and behind the ears. Around the mouth and lower jaw of the child, flushing may occur, most commonly resulting from baby food or saliva. The skin of the body, legs and arms of the infant are extremely dry. The itching occurs several weeks after the rash, and there are traces of scratching. Often babies’ sleep is disturbed.
In older children, the pronounced dryness of the skin is the main symptom. The skin is coarse and flaky. This is due to prolonged friction of skin areas and occurs most commonly in the area of the folds, the neck and the back of the legs and arms, and the itching is very strong. The face is pale, and around the eyes the skin is red and flaky.
In adult patients, pruritus is present throughout the day and gets worse at night, resulting in disturbed sleep and quality of life. The rashes are enlarged, darkened and scattered throughout the body. In more severe cases, the face is evenly reddened.
Treatment of atopic dermatitis should be started as soon as possible after diagnosis and managed by a dermatologist. It includes a set of measures:
Medication treatment – the most commonly used medications are local anti-inflammatory drugs. In cases of severe skin involvement of a large skin area, internal treatments are used, using systemic antibiotics (to control accumulated bacterial infections), antimycotic agents (to suppress the development of fungal infections) and, in the most severe cases, systemic immunosuppressive agents.
Phototherapy – a combination of ultraviolet rays is used in many chronic cases. It has a pronounced anti-inflammatory effect on inflamed skin areas.
Appropriate hygiene regimen – the use of soft soaps to protect the skin’s protective barrier as well as the continued use of suitable and maximally non-irritating skin lubricants, adherence to the necessary diet, building habits for sufficient movement, sleep and photo protection.