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  Atopic Dermatitis

What is atopic dermatitis?

Atopic dermatitis, also called eczema, is an allergic skin disorder that usually appears in babies or very young children, and may last until the child reaches adolescence or adulthood. Eczema causes the skin to itch, scale, and flake.

Parents with eczema are more likely to have children with eczema. Different triggers can make eczema worse, including stress, other allergies, and sweating. Of children who have eczema, 60% will show signs in their first year of life and 85% will show signs of eczema in the first 5 years.

What are the symptoms of eczema?

The location on the body that is affected by eczema tends to change with age. In infants and young children, the dry skin is usually located on the face, outside of the elbows, and on the knees. In older children and adults, eczema tends to occur on the hands and feet, the front of the arms, and on the back of the knees.

The following are the most common symptoms of eczema:

  • dry, scaly skin
  • small bumps that open when scratched
  • redness and swelling of the skin
  • a thickening and hardening of the skin (with chronic eczema)

Excessive rubbing and scratching can tear the skin and cause an infection. Some children only have a few episodes of flare-ups, while other children will have atopic dermatitis throughout adulthood.

The symptoms of eczema may resemble other skin conditions. Always consult your child's physician for a diagnosis.

How is eczema diagnosed?

Atopic dermatitis is very common. The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that about 10% of infants and children have atopic dermatitis. Diagnosis is usually based on a physical examination and complete medical history. Diagnosis may also include the following:
  • family history (children born to a mother who has allergic conditions are more prone to eczema.)
  • personal history of allergies or asthma
  • blood tests
  • skin test
Treatment for eczema:

Specific treatment for eczema will be determined by your child's physician based on:
  • your child's age, overall health, and medical history
  • extent of the reaction
  • your child's tolerance for specific medications, procedures, or therapies
  • expectations for the course of the reaction
  • your opinion or preference
There is no cure for eczema. The main goal of treatment is to remove any irritants and decrease the amount of dryness and irritation.

Management of eczema symptoms:

The following are suggestions for the management of eczema:
  • Avoid contact with irritants, as determined by your child's physician.
  • Bathe your child less frequently, use moisturizers, and practice good skin care techniques.
  • Do not use harsh soaps. Ask your child's physician for a brand he/she would recommend that will not cause the skin to become further irritated.
  • Make sure your child's fingernails are short, as scratching may cause an infection.
  • Use lubricating lotions at least once a day. Ask your child's physician for a brand he/she would recommend that will not cause the skin to become further irritated.
  • Dress your child in light clothes-sweating can make eczema worse.
  • Avoid oils and grease on the skin-this may cause more sweating and itching.

Your child's physician may also prescribe medications in severe cases. The following medications are most commonly used to treat eczema:
  • Antihistamines   These medications help to decrease the amount of itching. Some examples are diphenhydramine (Benadryl? or hydroxyzine (Atarax®). These medications may cause drowsiness. Some new antihistamines are also available that do not cause drowsiness. Consult your child's physician for more information.
  • steroid creams   These topical medications help to decrease the inflammation in the skin, thus, decreasing the itching and swelling. This helps with itching and swelling. Some examples are hydrocortisone ointments, mometasone (Elocon®), or triamcinolone (Kenalog®).

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