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1. What is atopic
dermatitis?
The word "atopic" describes a group of allergic or associated
diseases that often affect several members of a family. These families
may have allergies such as hay fever, asthma, or a sinus condition
but also have skin eruptions called atopic dermatitis. Atopic dermatitis
is very common in all parts of the world. It affects about ten percent
of infants and three percent of the U.S. population overall. The
disease can occur at any age but is most common in infants to young
adults. The skin rash is very itchy. The condition usually improves
in childhood or sometime before the age of 25.
2. What does atopic
dermatitis look like?
When the disease starts in infancy, redness, itching, and blistering
tend to occur mainly on the face and scalp, although spots can appear
elsewhere. In attempts to relieve the itching, the child may rub
his or her head and cheeks and other affected areas with a hand,
a pillow, or anything within reach. Parents should know that many
babies improve before two years of age. If the disease continues
or occurs beyond infancy, the skin has less tendency to be red,
blistering, oozing and crusting. Instead, the lesions become dry,
red to brownish-gray, and the skin may be scaly and thickened. An
intense, almost unbearable itching can continue, becoming severe
at night. Some patients scratch at the skin until it bleeds and
crusts. When this occurs, the skin may become infected. In teens
and young adults, the eruptions typically occur on the elbow bends
and backs of the knees, ankles and wrists and on the face, neck
and upper chest.
3. Can certain foods
cause atopic dermatitis?
Yes. Although some foods may provide attacks, especially in infants
and young children, eliminating them rarely will bring about lasting
improvement or a cure. If all else fails, foods such as cow's milk,
soy, eggs, fish, wheat, peanuts and other foods can be avoided at
least for one to two weeks on a trial basis.
4. Are environmental
causes important, and should they be eliminated?
Rarely does the elimination of contact or airborne substances bring
about lasting relief. Occasionally dust and dust-catching objects
like feather pillows, down comforters, kapok pillows and mattresses,
carpeting, drapes, some toys, and wool along with other rough fabrics,
can cause the condition to worsen.
5. Are skin tests, like
those given for hay fever or asthma, of any value in finding the
causes?
A positive test signals allergy only about 20 percent of the time.
If negative, the test is good evidence against allergy.
6. Are allergy "shots"
such as those given for hay fever useful?
Not usually, and they may even make the skin condition worse in
some patients.
7. What can be done
to treat atopic dermatitis?
Irritating factors in creams and lotions, rough and scratchy or
tight clothing and woolens, rapid changes of temperature and any
activity that provokes sweating can be eliminated. Other important
treatment factors are proper bathing, frequent moisturization and
dealing with emotional upsets which make the condition worse.
Your dermatologist can prescribe external medications
such as corticosteroid (cortisone)
creams or ointments and internal medications such as antihistamines
to control the itching. Oral antibiotics are prescribed if there
is a secondary infection. When other measures have failed, your
physician may prescribe systemic corticosteroids (cortisone)
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