Atopic dermatitis (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy | Atopic dermatitis is a long-term (chronic) [[skin]] disorder that involves scaly and itchy [[rash]]es. | ||
==What are the symptoms of Atopic dermatitis?== | ==What are the symptoms of Atopic dermatitis?== | ||
Skin changes may include: | Skin changes may include: | ||
* | * [[Blister]]s with oozing and crusting | ||
* Dry skin all over the body or areas of bumpy skin on the back of the arms and front of the thighs | * [[Dry skin]] all over the body or areas of bumpy skin on the back of the arms and front of the thighs | ||
* Ear discharge or bleeding | * Ear discharge or bleeding | ||
* Raw areas of the skin from scratching | * Raw areas of the [[skin]] from scratching | ||
* Skin coloring changes, such as more or less color than the normal skin tone | * Skin coloring changes, such as more or less color than the normal skin tone | ||
* Skin redness or inflammation around the blisters | * Skin redness or [[inflammation]] around the blisters | ||
* Thickened or leather-like areas (called lichenification), which can occur after long-term irritation and scratching | * Thickened or leather-like areas (called [[lichenification]]), which can occur after long-term irritation and scratching | ||
* The type and location of the rash can depend on the age of the patient: | * The type and location of the [[rash]] can depend on the age of the patient: | ||
In children younger than age 2, skin lesions begin on the face, scalp, hands, and feet. The rash is often itchy and bubble, ooze, or form crusts. | In children younger than age 2, skin lesions begin on the face, scalp, hands, and feet. The rash is often itchy and bubble, ooze, or form crusts. | ||
* In older children and adults, the rash is more often seen on the inside of the | * In older children and adults, the [[rash]] is more often seen on the inside of the [[knee]]s and [[elbow]]. It can also appear on the neck, hands, and feet. | ||
* Rashes may occur anywhere on the body during a bad outbreak. | * Rashes may occur anywhere on the body during a bad outbreak. | ||
* Intense itching is common. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the skin rash follows as a result of scratching. | * Intense [[itching]] is common. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the [[skin rash]] follows as a result of scratching. | ||
==What causes Atopic dermatitis?== | ==What causes Atopic dermatitis?== | ||
Atopic dermatitis is due to a skin reaction (similar to an allergy) in the skin. The reaction leads to ongoing swelling and redness. People with atopic dermititis may be more sensitive because their skin lacks certain | Atopic dermatitis is due to a skin reaction (similar to an allergy) in the skin. The reaction leads to ongoing [[swelling]] and redness. People with atopic dermititis may be more sensitive because their skin lacks certain [[protein]]s. | ||
Atopic dermatitis is most common in | Atopic dermatitis is most common in [[infant]]s. It may start as early as age 2 to 6 months. Many people outgrow it by early adulthood. | ||
People with atopic dermatitis often have asthma or seasonal allergies. There is often a family history of allergies such as asthma, hay fever, or eczema. People with atopic dermatitis often test positive to allergy skin tests.However, atopic dermatitis is not caused by allergies. | People with atopic dermatitis often have [[asthma]] or seasonal allergies. There is often a family history of allergies such as asthma, hay fever, or [[eczema]]. People with atopic dermatitis often test positive to allergy skin tests.However, atopic dermatitis is not caused by allergies. | ||
The following can make atopic dermatitis symptoms worse: | The following can make atopic dermatitis symptoms worse: | ||
| Line 36: | Line 36: | ||
* Contact with irritants and chemicals | * Contact with irritants and chemicals | ||
* Contact with rough materials, such as wool | * Contact with rough materials, such as wool | ||
* Dry skin | * [[Dry skin]] | ||
* Emotional stress | * Emotional stress | ||
* Drying out of the skin from taking too many baths or showers and swimming too often | * Drying out of the skin from taking too many baths or showers and swimming too often | ||
| Line 42: | Line 42: | ||
* Perfumes or dyes added to skin lotions or soaps | * Perfumes or dyes added to skin lotions or soaps | ||
==Diagnosis== | ==Diagnosis== | ||
The health care provider will give you an exam and look at your skin. A physical exam will be done. You may need a skin biopsy | The health care provider will give you an exam and look at your skin. A physical exam will be done. You may need a [[skin biopsy]] to confirm the diagnosis or rule out other causes of dry, itchy skin. | ||
Diagnosis is based on the: | Diagnosis is based on the: | ||
| Line 51: | Line 51: | ||
* Hard-to-treat atopic dermatitis | * Hard-to-treat atopic dermatitis | ||
* Other allergy symptoms | * Other allergy symptoms | ||
* Skin | * [[Skin rash]]es that form only on certain areas of the body after exposure to a specific chemical | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
Call your health care provider if: | Call your health care provider if: | ||
| Line 58: | Line 58: | ||
* Symptoms get worse or treatment does not work | * Symptoms get worse or treatment does not work | ||
* You have signs of infection (such as fever, redness, or pain) | * You have signs of infection (such as fever, redness, or pain) | ||
==Treatment options== | ==Treatment options== | ||
SKIN CARE AT HOME | SKIN CARE AT HOME | ||
Daily skin care make cut down on the need for medicines. | Daily skin care make cut down on the need for medicines. | ||
Avoid scratching the rash or skin: | Avoid scratching the rash or skin: | ||
* Use a moisturizer, topical steroid cream, or other medicine your doctor prescribes. | * Use a moisturizer, topical steroid cream, or other medicine your doctor prescribes. | ||
* Take antihistamine medicines by mouth to reduce severe itching. | * Take [[antihistamine]] medicines by mouth to reduce severe itching. | ||
* Keep fingernails cut short. Wear light gloves during sleep if nighttime scratching is a problem. | * Keep fingernails cut short. Wear light gloves during sleep if nighttime scratching is a problem. | ||
* Keep the skin moist (called lubricating or moisturizing the skin). Use | * Keep the skin moist (called lubricating or moisturizing the skin). Use [[ointment]]s (such as petroleum jelly), creams, or lotions 2 - 3 times a day. Choose skin products that are free of [[alcohol]], [[scent]]s, [[dye]]s, and other [[chemical]]s. A humidifier to keep home air moist will also help. | ||
Avoid things that make your symptoms worse, such as: | Avoid things that make your symptoms worse, such as: | ||
* Foods that may cause an allergic reaction such as | * Foods that may cause an [[allergic reaction]] such as [[egg]]s in a very young child (always talk to your doctor first) | ||
* Irritants such as wool and lanolin | * Irritants such as wool and lanolin | ||
* Strong soaps or detergents, as well as | * Strong soaps or detergents, as well as [[chemical]]s and [[solvent]]s | ||
* Sudden changes in body temperature and stress, which may cause sweating | * Sudden changes in body temperature and stress, which may cause sweating | ||
* Triggers that cause allergy symptoms | * Triggers that cause [[allergy]] symptoms | ||
When washing or bathing: | When washing or bathing: | ||
* Expose your skin to water for as short a time as possible. Short, cooler baths are better then long, hot baths. | * Expose your skin to water for as short a time as possible. Short, cooler baths are better then long, hot baths. | ||
* Use gentle body | * Use gentle [[body wash]]es and cleansers instead of regular soaps. | ||
* Do not scrub or dry the skin too hard or for too long | * Do not scrub or dry the [[skin]] too hard or for too long | ||
* Apply lubricating creams, lotions, or ointment to the skin after bathing while it is damp. This will help trap moisture in the skin. | * Apply lubricating creams, lotions, or ointment to the skin after bathing while it is damp. This will help trap moisture in the skin. | ||
MEDICATIONS | MEDICATIONS | ||
At this time, allergy shots are not used to treat [[atopic dermatitis]]. | |||
At this time, allergy shots are not used to treat atopic dermatitis. | |||
Antihistamines taken by mouth may help with itching or allergies. You can often buy these medicines without a prescription. | Antihistamines taken by mouth may help with itching or allergies. You can often buy these medicines without a prescription. | ||
Most causes of atopic dermatitis are treated with medicines placed directly on the skin or scalp (called topical medicines): | Most causes of atopic dermatitis are treated with medicines placed directly on the skin or scalp (called topical medicines): | ||
* You will probably be prescribed a mild cortisone (or | * You will probably be prescribed a mild [[cortisone]] (or s[[teroid]]) cream or ointment at first. You may need a stronger medicine if this doesn't work. | ||
* Medicines called topical | * Medicines called topical [[immunomodulator]]s (TIMs) may be prescribed for anyone over 2 years old. TIMs include [[tacrolimus]](protopic) and [[pimecrolimus]] (Elidel). Ask your doctor about concerns over a possible cancer risk with the use of these medicines. | ||
* Creams or ointments that contain coal tar or anthralin may be used for thickened areas. | * Creams or ointments that contain coal tar or [[anthralin]] may be used for thickened areas. | ||
* Barrier repair creams containing ceramides may be used. | * Barrier repair creams containing ceramides may be used. | ||
* Wet-wrap treatment with topical | * Wet-wrap treatment with topical [[corticosteroid]]s may help control the condition but may lead to an [[infection]]. | ||
Other treatments that may be used include: | Other treatments that may be used include: | ||
* Antibiotic creams or pills if the skin is infected | * [[Antibiotic]] creams or pills if the skin is infected | ||
* | * [[Drug]]s that suppress the [[immune system]], such as [[cyclosporine]], [[methotrexate]], or [[mycophenolate mofetil]] | ||
* Phototherapy, a medical treatment in which your skin is carefully exposed to ultraviolet (UV) light | * [[Phototherapy]], a medical treatment in which your skin is carefully exposed to ultraviolet (UV) light | ||
* Short-term use of systemic steroids | * Short-term use of systemic steroids | ||
==Where to find medical care for Atopic dermatitis?== | ==Where to find medical care for Atopic dermatitis?== | ||
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Condition}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wlDirections to Hospitals Treating Atopic dermatitis] | [http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Condition}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wlDirections to Hospitals Treating Atopic dermatitis] | ||
==Prevention== | ==Prevention== | ||
Children who are breast-fed until age 4 months are less likely to get atopic dermatitis. | Children who are breast-fed until age 4 months are less likely to get atopic dermatitis. | ||
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* Begins at an early age | * Begins at an early age | ||
* Involves a large amount of the body | * Involves a large amount of the body | ||
* Occurs along with allergic rhinitis and asthma | * Occurs along with [[allergic rhinitis]] and [[asthma]] | ||
* Occurs in someone with a family history of eczema | * Occurs in someone with a family history of [[eczema]] | ||
==Possible complications== | ==Possible complications== | ||
* Infections of the skin caused by bacteria, fungi, or | * Infections of the [[skin]] caused by [[bacteria]], [[fungi]], or [[virus]]es | ||
* Permanent scars | * Permanent scars | ||
* Side effects from long-term use of medicines to control eczema | * Side effects from long-term use of medicines to control [[eczema]] | ||
==Sources== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/ency/article/000853.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000853.htm | ||
[[Category:Patient information]] | [[Category:Patient information]] | ||
[[Category:Autoimmune diseases]] | |||
[[Category:Dermatology]] | |||
[[Category:Primary care]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 19:41, 19 March 2013
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Atopic dermatitis |
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Atopic dermatitis On the Web |
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes.
What are the symptoms of Atopic dermatitis?
Skin changes may include:
- Blisters with oozing and crusting
- Dry skin all over the body or areas of bumpy skin on the back of the arms and front of the thighs
- Ear discharge or bleeding
- Raw areas of the skin from scratching
- Skin coloring changes, such as more or less color than the normal skin tone
- Skin redness or inflammation around the blisters
- Thickened or leather-like areas (called lichenification), which can occur after long-term irritation and scratching
- The type and location of the rash can depend on the age of the patient:
In children younger than age 2, skin lesions begin on the face, scalp, hands, and feet. The rash is often itchy and bubble, ooze, or form crusts.
- In older children and adults, the rash is more often seen on the inside of the knees and elbow. It can also appear on the neck, hands, and feet.
- Rashes may occur anywhere on the body during a bad outbreak.
- Intense itching is common. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the skin rash follows as a result of scratching.
What causes Atopic dermatitis?
Atopic dermatitis is due to a skin reaction (similar to an allergy) in the skin. The reaction leads to ongoing swelling and redness. People with atopic dermititis may be more sensitive because their skin lacks certain proteins.
Atopic dermatitis is most common in infants. It may start as early as age 2 to 6 months. Many people outgrow it by early adulthood.
People with atopic dermatitis often have asthma or seasonal allergies. There is often a family history of allergies such as asthma, hay fever, or eczema. People with atopic dermatitis often test positive to allergy skin tests.However, atopic dermatitis is not caused by allergies.
The following can make atopic dermatitis symptoms worse:
- Allergies to pollen, mold, dust mites, or animals
- Cold and dry air in the winter
- Colds or the flu
- Contact with irritants and chemicals
- Contact with rough materials, such as wool
- Dry skin
- Emotional stress
- Drying out of the skin from taking too many baths or showers and swimming too often
- Getting too hot or too cold, as well as sudden changes of temperature
- Perfumes or dyes added to skin lotions or soaps
Diagnosis
The health care provider will give you an exam and look at your skin. A physical exam will be done. You may need a skin biopsy to confirm the diagnosis or rule out other causes of dry, itchy skin.
Diagnosis is based on the:
- How the skin looks
- Personal and family history
Allergy skin testing may be helpful for people with:
- Hard-to-treat atopic dermatitis
- Other allergy symptoms
- Skin rashes that form only on certain areas of the body after exposure to a specific chemical
When to seek urgent medical care?
Call your health care provider if:
- Atopic dermatitis does not get better with home care
- Symptoms get worse or treatment does not work
- You have signs of infection (such as fever, redness, or pain)
Treatment options
SKIN CARE AT HOME
Daily skin care make cut down on the need for medicines.
Avoid scratching the rash or skin:
- Use a moisturizer, topical steroid cream, or other medicine your doctor prescribes.
- Take antihistamine medicines by mouth to reduce severe itching.
- Keep fingernails cut short. Wear light gloves during sleep if nighttime scratching is a problem.
- Keep the skin moist (called lubricating or moisturizing the skin). Use ointments (such as petroleum jelly), creams, or lotions 2 - 3 times a day. Choose skin products that are free of alcohol, scents, dyes, and other chemicals. A humidifier to keep home air moist will also help.
Avoid things that make your symptoms worse, such as:
- Foods that may cause an allergic reaction such as eggs in a very young child (always talk to your doctor first)
- Irritants such as wool and lanolin
- Strong soaps or detergents, as well as chemicals and solvents
- Sudden changes in body temperature and stress, which may cause sweating
- Triggers that cause allergy symptoms
When washing or bathing:
- Expose your skin to water for as short a time as possible. Short, cooler baths are better then long, hot baths.
- Use gentle body washes and cleansers instead of regular soaps.
- Do not scrub or dry the skin too hard or for too long
- Apply lubricating creams, lotions, or ointment to the skin after bathing while it is damp. This will help trap moisture in the skin.
MEDICATIONS
At this time, allergy shots are not used to treat atopic dermatitis.
Antihistamines taken by mouth may help with itching or allergies. You can often buy these medicines without a prescription.
Most causes of atopic dermatitis are treated with medicines placed directly on the skin or scalp (called topical medicines):
- You will probably be prescribed a mild cortisone (or steroid) cream or ointment at first. You may need a stronger medicine if this doesn't work.
- Medicines called topical immunomodulators (TIMs) may be prescribed for anyone over 2 years old. TIMs include tacrolimus(protopic) and pimecrolimus (Elidel). Ask your doctor about concerns over a possible cancer risk with the use of these medicines.
- Creams or ointments that contain coal tar or anthralin may be used for thickened areas.
- Barrier repair creams containing ceramides may be used.
- Wet-wrap treatment with topical corticosteroids may help control the condition but may lead to an infection.
Other treatments that may be used include:
- Antibiotic creams or pills if the skin is infected
- Drugs that suppress the immune system, such as cyclosporine, methotrexate, or mycophenolate mofetil
- Phototherapy, a medical treatment in which your skin is carefully exposed to ultraviolet (UV) light
- Short-term use of systemic steroids
Where to find medical care for Atopic dermatitis?
to Hospitals Treating Atopic dermatitis
Prevention
Children who are breast-fed until age 4 months are less likely to get atopic dermatitis.
If a child is not breast-fed, using a formula that contains processed cow milk protein (called partially hydrolyzed formula) may cut down on the chances of developing atopic dermatitis.
What to expect (Outlook/Prognosis)?
Atopic dermatitis is a long-term condition. You can control it with treatment, by avoiding irritants, and by keeping the skin well-moisturized. In children, the condition often starts to go away around age 5 - 6, but flare-ups will often occur. In adults, the problem is generally a long-term or returning condition. Atopic dermatitis may be harder to control if it:
- Begins at an early age
- Involves a large amount of the body
- Occurs along with allergic rhinitis and asthma
- Occurs in someone with a family history of eczema
Possible complications
- Infections of the skin caused by bacteria, fungi, or viruses
- Permanent scars
- Side effects from long-term use of medicines to control eczema