Atopic Dermatitis

Atopic dermatitis fact file

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1. Atopic dermatitis affects a fifth of children.1

Atopic dermatitis affects approximately 20% of children; 25% of those with moderate-to-severe disease in childhood will continue to have atopic dermatitis as adults.1

   

Children with atopic dermatitis have a 50% risk of developing asthma and 75% risk of developing hay fever.1

2. Symptoms of atopic dermatitis can vary according to age.2

In infants, atopic dermatitis tends to present as widely distributed red, dry, scaly skin and frequently affects the cheeks and nappy area.2

In toddlers, the skin affected by atopic dermatitis can be more localised and thickened, with the extensor areas (such as elbows and knees) particularly affected.2

As children get older, atopic dermatitis tends to affect the flexures of the limbs (the creases of the elbow and knee), and often affects the neck, eyelids and scalp.2

3. Atopic dermatitis is caused by genetic and environmental factors.2

Atopic dermatitis is a chronic inflammatory condition. It is thought that in patients with the condition, genetic factors lead to the breakdown of the skin barrier (loss of function of the protein filaggrin), which makes it susceptible to triggers, such as environmental factors.3

4. Triggers of atopic dermatitis include stress and allergens.4

A number of potential triggers of atopic dermatitis have been identified, which include stress, allergens, microorganisms (such as S. aureus), auto-antigens and irritant factors (including chemical and mechanical irritants).4

5. Differential diagnoses of atopic dermatitis include other types of eczema.4

Physical examination and medical history play an important role in the diagnosis of atopic dermatitis.

As the clinical manifestations of atopic dermatitis may be similar to other dermatological conditions, differential diagnoses, such as other types of eczema and psoriasis, should be considered.
Careful consideration of potential triggers and allergens is required in addition to personal and familial history of atopic conditions.3,4

6. Food irritants, skin infections and certain soaps can be irritants of atopic dermatitis.4

Other irritants include detergents, perfumes, dust or sand, and cigarette smoke. Following identification of triggers, patients should be advised to avoid triggers and irritants where possible.4

7. Emollients (creams that soften and smooth skin) play an important role management of atopic dermatitis.4

In addition to moisturising the skin, emollients provide a protective coating over the skin and help prevent water loss. Emollients should be applied continuously, even if the condition of the skin has improved.4

8. Medication to reduce inflammation, relieve itching and prevent future flare-ups can be administered.5

In addition to the continuous application of emollients, topical steroids can be applied during flare-ups (topical immunomodulators can be administered as steroid-sparing agents). In the case of secondary bacterial infections or secondary herpes infection, antibiotics or antivirals may be required.5

9. Atopic dermatitis can affect quality of life.3

Atopic dermatitis can impact everyday activities and disrupt sleep.13 The impact of the condition on the patients’ psychosocial wellbeing should be considered and addressed, particularly for children.3

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