Atopic dermatitis

Atopic dermatitis (or atopic eczema) is a sort of skin inflammation that causes flushing, dryness or small bubbles and intense itching. It affects people of all ages and represents the result of an abnormal skin reaction to some substances normally present in our environment. In fact, the word eczema is derived from an ancient greek definition that – literally translated – means “to boil over”. Substantially it is a genetic pathology, that means that within a family there can be two or more people affected by eczema, allergic rhinitis or asthma. All kinds of this disease have a single common denominator: an abnormal body reaction to an external, environmental,
contact-induced, inhalatory, alimentary or drug-induced stimulus.
ECZEMA IN CHILDREN
In childhood the atopic eczema may appear from birth with the crusta lactea: in the first months of life reddened, dry and itching spots arise especially around the mouth and face, as well as behind the ears, along the folds of neck and arms and behind the knees; then, they gradually disappear during growth.
Most children present a remarkable skin improvement at the age of approximately 5 years. Respiratory disorders, like for instance spastic or asthmatic bronchitis, may arise toward the school age until puberty. Only a few patients continue to present an incidence of the pathology in adulthood.
Children with eczema are predisposed to cutaneous infections just because they continually scratch their skin as a consequence of the itching. Furthermore, often abrasions are also present on the skin. Small patients affected by atopic eczema are also predisposed to herpes (caused by the virus of herpes simplex). The contact itself with the virus may lead to a widespread infection. Therefore, it is absolutely necessary to keep the child far from whoever shows signs of herpes in active phase (the so-called “fever blister”). It is also important to remember that children affected by atopic eczema are predisposed to verrucas.
PRACTICAL ADVICE
Is there a method to prevent manifest atopic eczema in a predisposed child?
In new-born babies and sucklings it is absolutely important to consider replace the milk (mother’s milk, too) with specific milk for atopy or with soya milk; later it will be necessary to reduce the amount of dairy products and foods rich in seeds (e.g. tomatoes, berries, chocolate, seed oil, etc.). There are valid practical cunnings that may be certainly useful and may contribute to improve the disease. Particular attention must be payed to excessive heat that may contribuite to develop the eczema. Pillows, quilts and heavy jackets must not be filled with feathers, they must be synthetic, have gore-tex slips and linings and on the surface they must be covered by pure cotton material. Underwear must be in white cotton and must be washed with Marseilles soap without additives. It is absolutely important to air the house and the rooms where affected children often stay, as well as to hoover with steam at 100 degrees celsius for destroying dust mites. Avoid keeping plants and animals in the house as air, feathers and pollens or dust deposits on leaves represent arising factors. Humidity in general favours the growth of fungus and moulds that may contribuite to the development of allergic reactions. Water, too – especially if “hard” – may cause skin irritation: a good filter can significantly help to prevent the disease and to stop its development.
It is also indispensable to use detergents and soft oil-based, non-foaming shampoos.
In conclusion, it must be remembered that in the course of their life children affected by atopic eczema have more chances than others on developing forms of asthma and allergic rhinitis. Also in this case an adequate prevention is absolutely necessary to avoid such pathologies in the future.
ATOPIC DERMATITIS IN ADULTS
From childhood until adulthood atopic dermatitis is often a constant fellow. It can worsen in certain situations, maybe under the influence of stress, moments of tiredness, hormonal, dietary or climatic modifications, etc. Besides children, basic rules and practical advice avail adults, too. They suggest, for instance, to keep daily a good hygiene by taking quick baths and showers without “strong” detergents, but always using instead only soft and non-foaming products; or to apply every day emollients enriched with Omega-6 and thermal waters for achieving a constantly soft and moisturized skin.
Be careful of excessively warm baths, irritating and sensitizing substances, perfumes, eau de toilette and inadequate creams or cosmetics.
Some foods as well may provoke allergic reactions in subjects predisposed to atopic dermatitis. Cucumbers and tomatoes, for example, can be considered responsible for many kinds of small bubbles and sudden itching. Cigarette smoke may cause skin irritation and an excessively warm room where smoking people are staying may often represent a real danger for those who suffer from atopic eczema. Analogously dogs and cats (also animal hair represents a potential source of development for the pathology) and the notorious dust mite may worsen the disease with their presence. One last bit of advice: in case of atopic dermatitis it is absolutely important to use specific and dermatologically tested products. The appropriate cream, detergent and lotion can often help significantly avoid the problem or quickly improve an already compromised situation.
MEDICAL THERAPY
Together with the traditional use of cortisone creams (nowadays indicated
only for the most serious cases and over a very short period of time) the treatment with a TACROLIMUS-based immunomodulatory drug can be considered specific and very effective. Its application as a cream or ointment on the inflammed skin areas – according to the dermatologist`s advice – allows to achieve temporarily resolutive results.
This is combined with the oral assumption of specific probiotics (specific milk enzymes) that partially reduce the arising effect of some incriminated foods. At last, in cases complicated by recurrent respiratory phenomena (e.g. bronchitis) it is associated the oral assumption of MONTELUKAST, an active principle that works on respiratory receptors.
For associated forms of conjunctivitis there are specific collyria with SODIUM CROMOGLYCATE, effective in reducing lachrymation, swelling and itching of eyes and eyelids.