Atopic Dermatitis

What is Atopic Dermatitis

Atopic Dermatitis (AD) is the cutaneous expression of the atopic state. It is characterised by a family history of asthma, hav fever, or dermatitis in upto 70% of patients. The etiology of Atopic Dermatitis is partially defined. There is a clear genetic predisposition.

Pruritus is a prominient characteristic of Atopic Dermatitis, and many of the cutaneous findings in affected patients are secondary to rubbing and scratching. Historical examination of the skin affected by Atopic Dermatitis may demonstrate features of acute or chronic dermatitis.

What causes Atopic Dermatitis

When both patents are affected by Atopic Dermatitis, over 80% of their children manifest the disease. A number of genes have been tentatively linked to Atopic Dermatitis including genes coding for IgE, the high-affinity IgE recepter, mast cell trypaste, and interleukin.

Atopic Dermatitis sign and symptoms

Patients with Atopic Dermatitis may display a variety of immunoregulatory abnormailities. The clinical presentation often varies with age. Half of patients with Atopic Dermatitis present within the first year of life, 80% present by 5 years of age. The infantile pattern of Atopic Dermatitis is characterised by weeping inflammatory patches and crushed plaques that occur on the face, neck, extensor surfaces and groin.

Critical criteria for disgnosis of Atopic Dermatitis

Pruritius and scratching
course marked by exacerbations and remissions
lessions typical of eczematous dermatitis
personal or family history of atopy
clinical course lasting longer than 6 weeks

Treatment and Cure of Atopic Dermatitis

Threapy of Atopic Dermatitis should be based on avoidance of curtaneous irritants, adequate curtaneous hydration, judicious use of low - midpotency topical glucocorticoids, and prompt treatment of secondarily infected skin leisions.

Patient should be instructed to bathe using warm, but not hot, water and to limit their use of soap.

The role of dietary allergens in Atopic Dermatitis is controversial, and there is little evidence that they play any role outside of infancy. Control of pruritus is essential fro treatment, since Atopic Dermatitis often represents "an itch that rashes".

Treatment with systemic gluccorticoids should be limided to severe exacerbations unresponsive to conservative atopic therapy.