Atopic Dermatitis ( Eczyma )

1. What is atopic dermatitis (Eczyma)?

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. 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 tends to occur mainly on the face and scalp, although spots can appear elsewhere. In attempts to relieve the itching, the child may rub their 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 kids 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 give for hay fever useful?

Not usually, 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, scratchy or tight clothing and woolens, rapid changes of temperature and any activity that provokes sweating can be eliminated. Proper bathing, frequent moisturization and dealing with emotional upsets which make the condition worse.

Your pediatrician 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 all other measures have failed, your pediatrician may prescribe systemic corticosteroids (cortisone).