Eczema/atopic dermatitis
"Dermatitis" means
inflammation of skin. "Atopic" dermatitis is a particular type of skin
inflammation that is marked by dryness, associated itching, and a characteristic
pattern of rash on the body. The condition is fairly common and may occur in as
many as ten percent of children.
What causes it?
The exact cause of atopic
dermatitis is unknown. In many patients, there is a family history of hay fever,
asthma or atopic dermatitis itself. Rarely, atopic dermatitis in infants may be
related to food sensitivity, such as sensitivity to milk, but this is often
difficult to determine and manage. In the majority of cases, however, no
allergic triggers can be found.
What are the symptoms?
Atopic dermatitis
usually starts in infancy from the ages of 2 to 6 months. The skin is dry, and
the rash is quite itchy, so infants may be restless and rub against the sheets
or scratch if able. The rash may involve the face or it may cover a large part
of the body. As the child gets older, the rash may become more localized. In
early childhood, the rash is commonly on the legs, feet, hands and arms. As a
person becomes older, the rash may be limited to the bend of the elbows, knees,
on the back of the hands, feet, and on the neck and face.
As the rash becomes more established, the dry itchy skin may become
thickened, leathery and sometimes darker in coloration. The more the person
scratches, the worse the rash is and the thicker the skin gets. Many children
with atopic dermatitis outgrow the condition before school age; some continue to
have problems as an adolescent or even as an adult.
Many things may affect the severity of the condition. All patients have
sensitive and dry skin. Many find that during the winter months when the
humidity is very low, the dryness and itchiness is worse. On the other hand,
some people are easily irritated by sweat and find that they have more problems
during the summer months. Most patients note an increase in itching during
sudden temperature changes.
Other irritants easily affect the skin of a patient with atopic dermatitis.
Use of harsh soaps and detergents and exposure to wool are common problems.
Sometimes atopic dermatitis may become infected by bacteria, yeast, or viruses;
this is called "secondary infection." Bacterial secondary infection is the most
common type of infection and often occurs as the result of scratching. The rash
gets very red with pus-filled pimples and scabs. If this occurs, your doctor
will prescribe an antibiotic to control the infection. A more serious
complication can be caused by certain viruses. The "cold sore" virus (herpes
simplex) may cause a severe rash. If this is suspected, immediately contact your
doctor. The virus that causes molluscum also tends to spread rapidly in patients
with atopic dermatitis.