DERMATITIS, ATOPIC

General Information

DEFINITION--A chronic inflammatory disease of the skin that is often associated with other allergic disorders that affect the respiratory system, such as asthma or hay fever.

BODY PARTS INVOLVED--Skin.

SEX OR AGE MOST AFFECTED--Both sexes, but symptoms may be worse in females; children most commonly affected.

SIGNS & SYMPTOMS

• Itching rash in areas where heat and moisture are retained, such as skin creases of elbows, knees, neck, face, hands, feet, groin, genitals and around the anus.
• Dry, thickened skin in affected areas.
• Uncontrolled scratching (frequently unconscious).
• Chronic fatigue from loss of sleep due to severe itching.

CAUSES--Unknown, but probably inherited and probably related to immune-system overactivity.

RISK INCREASES WITH

• Hay fever or asthma.
• Food allergy.
• Family history of atopic dermatitis or other allergic disorders.
• Stress. The rash and itching increase during stressful periods.
• Use of immunosuppressive drugs.
• Irritating clothes and chemicals.
• Excessively hot or cold climate.

HOW TO PREVENT

• Decrease stress if possible.
• Avoid agents that cause irritation (wool, perfumes, fabric softeners, harsh soaps, etc.).
• Minimize sweating.
• Lukewarm, not hot baths.
• Lubricate skin frequently.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment with medication.

POSSIBLE COMPLICATIONS

• Secondary bacterial infection in the affected area.
• Cataracts ( more common in people with atopic dermatitis).
• Decreased resistance to fungal and viral infections.
• Permanent scarring from scratching.

PROBABLE OUTCOME--Unpredictable. Flare-ups and remissions may occur throughout life. It does tend to decrease or sometimes disappear with age.

How To Treat

GENERAL MEASURES--

• Effective treatment involves eliminating allergens, avoiding irritants and other precipitating factors and relieving itching and inflammation.
• Use cool-water soaks for crusting, oozing lesions. These decrease itching and remove crusts.
• Bathe in cool to warm water with cleansing agents other than soap.
• Keep fingernails short.
• Wear loose-fitting, cotton clothing (avoid wool and synthetics).
• Avoid fabric softeners and anti-static laundry products.
• Use petroleum- or lanolin-based ointments after bathing.
• Reduce stress in your life, if possible.

MEDICATION--

• To relieve minor itching, use non-prescription topical steroids or coal-tar preparations.
• For severe itching, your doctor may prescribe: More potent topical steroids. Oral cortisone drugs (rarely, and for short periods only). Antihistamines or mild tranquilizers. Lubricating ointments for the hands. Antibiotics (sometimes) to fight secondary infections.

ACTIVITY--No restrictions except to keep cool. Avoid prolonged exposure to heat.

DIET--An allergy diet may be helpful, if food allergy is suspected. Consult your doctor.

Call Your Doctor If

• You have symptoms of atopic dermatitis.
• You develop fever or uncontrolled itching during a flare-up.