Atopic dermatitis is what sometimes other individuals call as “skin allergy”. It is a recurring, peculiar cutaneous inflammatory condition with strong hereditary predisposition. The skin lesion can start out as early as infancy and progress to childhood and adolescence. It has a relapsing course and individuals with atopic dermatitis are additionally at risk for developing allergic rhinitis and asthma.

Just like allergic rhinitis and asthma, this sort of dermatitis can be set off by ingestion of food allergen and inhalation of inhalant allergens like house dust mite, mold and pollen. It can also be initiated by coarse clothes and mental stress.

Atopic dermatitis has 3 unique stages, each with quite characteristics features depending on the age of the patient.

The first stage is the infantile stage which typically starts during the 4th to 6th month. It presents as itchy, red rashes on the cheeks that distributes to the forehead, back of the arms, and anterior surface of the legs. Heavy scaling of the scalp is prominent. However, the skin near the mouth and eyelids are generally spared.

Between 2 and 4 years old, childhood phase gradually occurs and may follow the infantile stage, or it may appear a number of years later. Skin lesions are characterized as itchy, excoriated papules (little solid elevations on the skin with less than 1 cm diameter) on the face, anterior surface of the arms, and back of the legs. Owing to persistent irritation produced by scratching or rubbing off of these itchy lesions, the skin becomes hardened and leathery (known as lichenification). The individual also assumes the so-called “mask of atopic dermatitis” where there is whitish hue of the face. This phase may disappear before 10 years of age or continue into adulthood.

The adult stage of atopic dermatitis has the same characteristic skin lesions in childhood stage, but this time it involves the dorsal aspect of the hands and the upper eyelids.

Management of atopic dermatitis embraces two standard principles: (1) avoidance of environmental elements that may potentiate the itch-scratch cycle, and (2) great skin hydration in any stage of the illness. Here are some helpful tips that need special consideration.

1. Keep away from the following: -food allergens such as peanuts, eggs, milk, seafoods -inhalants (house dust mites, molds) -extreme change of temperature and humidity (This will lead to sweating and aggravate itching.)

2. Bodily irritants such as soaps, detergents, wool, silk, nylon, and other synthetic fabrics should also be avoided.

3. Hydrate the skin by bathing or soaking the affected area in tepid water for a period of 15 mins 2-3 times per day. After the bath, remove excess water by patting with soft towel. Then, apply proper topical steroid medication in 3-5 minutes. This kind of quick application will prevent evaporation and dryness of the skin, providing the advantage of increasing the penetration of the topical medicine.

4. Moisturizers in lotions or creams can also be applied 3-4 times daily, right after baths to add some moisture to the skin.

5. When used with hydration, occlusives like petroleum jelly or vegetable shortening are efficient in dry areas as they allow less evaporation.

6. Suspect secondary bacterial infections in the presence of acute weeping or cracking lesions. It is very best to seek the advice of a doctor as this will need antibiotic therapy.

Just like other long standing recurring diseases, individuals with atopic dermatitis need psychological support and education. Most of all, patients and parents need to be assured that the illness may be controlled, and that majority improve with age.

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