I would like to inform you about a very common skin disease that affects children, and at the same time raises several questions.
Atopic dermatitis, also known as atopic eczema, is a chronic and relapsing skin disease that usually starts in early childhood and is characterized by intense itching. Itching elicits the urge to scratch; constant itching and scratching can lead to lichenification (thickening of the skin), due to rubbing.
More specifically, there are three types of atopic dermatitis: infantile eczema, childhood eczema and adult atopic dermatitis. In infants and young children, eczema is usually located on the face and mainly on the cheeks, the hands, in the creases of the elbows, behind the knees, and on the whole torso. The lesions resemble acute dermatitis with redness and blisters or vesicles. Intense itching and scratching can tear the skin and result in an infection. In older lesions there is lichenification, i.e. the skin becomes thick, dry, and scaly.
The predisposition to atopic dermatitis is mostly hereditary and can be passed on from parents to children. Serum immunoglobulin IgE levels are elevated at 85-90%. Diagnosis is based on the clinical picture. Various foods (eggs, milk, pistachios, soy, fish and cereals), dust and germs may trigger a flare-up of atopic dermatitis.
Atopic dermatitis is often associated with a personal or family history of asthma, allergic rhinitis or atopic dermatitis. 35% of the infants who get eczema will also someday develop asthma themselves. 40% of the infants have a spontaneous, complete recession in childhood with few recurrences in adolescence. Many patients have the disease for 15-20 years. Caution is needed in infections caused by S. aureus (Staphylococcus aureus) and herpes simplex virus.
To manage eczema symptoms, it is extremely important to educate the patient so as to avoid rubbing and scratching. Antihistamines, topical or oral corticosteroids, and topical immunomodulators are used in the treatment of atopic dermatitis, while taking brief, lukewarm showers or baths and moisturizing regularly is a very important skin-care routine that will help the child feel better.
Finally, it has to be pointed out that every child or adult may experience the symptoms of the "disease" in different degrees of severity. That is why, patients should always consult their treating dermatologist for specific medical advice.