Atopic Dermatitis (AD)

 

DESCRIPTION

Atopic dermatitis (AD) is one of the most common forms of a more extensive condition known as eczema, which is a general descriptive term encompassing various inflammatory skin conditions. People with AD need to continually moisturize their skin to reduce the frequency and severity of flare-ups.

 

CAUSES

Although the precise cause of AD is unknown, it is linked to both genetic and environmental factors.

AD is an inherited condition. Studies indicate that children are more likely to develop the disease if one or both of their parents (particularly the mother) has had it, or if there is a family history of allergic conditions, such as asthma or hay fever.

 

OTHER FACTORS
  • Climate
  • Geographical regions
  • Abnormal response of the body's immune system

There are distinct phases in the progression of AD, which can begin in very early infancy. In fact, 75% to 90% of the approximately 15 million cases of AD in the United States are diagnosed before 3 months of age, and 60% of these cases persist throughout the patient's life.

The Phases of Atopic Dermatitis

Infant phase (birth to 2 years)

  • Initial signs of inflammation develop by 3 months of age
  • Patchy rash on the cheeks and chin may later progress to redness, scaling, and oozing, the classic presentation of infantile eczema
  • Other exposed areas of the skin, including the arms and legs, may be affected as the infant begins crawling
  • Infants with AD may be irritable and sleep fitfully because of itching and discomfort

Childhood phase (2 to 12 years)

  • Inflammation develops in the flexural areas (ie, insides of elbows, neck, wrists, and ankles) as a result of activity and perspiration
  • Burning and intense pruritus (itching) trigger the itch-scratch-itch cycle
  • Rash initially manifests as papules (bumps) that coalesce to form plaques, which can become hardened due to scratching
  • Skin around the lips may also be inflamed, and painful cracks may develop

Adult phase (12 years and up)

  • Disease pattern is similar to the childhood phase, including localized inflammation with thickening of the skin
  • One or more areas of the body may be involved
  • Inflammation of the flexural areas is common
  • Work performance and sleep may be adversely affected
  • Adults with AD are also predisposed to contact dermatitis caused by irritants (detergents, for instance)
  • Hand and foot eczema are more commonly present in adults and can be debilitating in terms of quality of life

As mentioned earlier, there are a number of things that can trigger worsening or a flare-up of AD. These factors can include temperature changes (both hot and cold), the amount of humidity in the air, excessive washing, airborne allergens, foods and emotional stress.

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