Atopic dermatitis(also known as eczema) – it’s an inflammation of the skin, the characteristic symptom of which is severe itching, redness and swelling of the skin.
Although the disease is the most common among children, it can also occur in adults – usually in chronic form.
Symptoms
Atopic dermatitis is the most common allergic skin disease.
85% of patients with atopic dermatitis are present in children before the age of 5.
The frequency of this disease is pretty high.
Symptoms depend on the patient’s age. There’s a possibility for AD symptoms to go away in childhood and for the disease to relapse more mildly in adulthood.
Most allergic reactions are seen among organs directly connected to the external environment – from the skin, respiratory and digestive systems.
The very first symptoms of AD are lesions in the form of redness,blisters and sometimes even oozing wounds.
After some time the skin is getting thick and dries out, forming visible furrows.
People with AD also have a higher probability of occurrence of allergic rhinitis or allergic asthma.
Chronic form of AD in adults
AD presented in adults usually has a varied and chronic course.
If AD began in childhood, the disease can develop additional respiratory-related symptoms with age, as well as food allergies.
In about 25% of adult AD patients, the very first symptoms of the disease don’t show up until adulthood. Most often, AD in adults appears around the age of 50.
In this case, usually AD doesn’t occur among other family members, and atypical symptoms prolong the period of diagnosis.
In adult AD patients, the characteristic symptom is a chronic, recurrent, red rash. Such skin lesions can fade on pressure and often occur symmetrically.
The most common symptoms of AD occur in the knee and elbow bends, on the neck and face, often around the eyes.
Causes and risk factors
The main cause of AD is a genetic abnormality of the skin.
The main protein responsible for the normal structure of epidermal cells through the bonding of keratin fibres is filaggrin.
Keratin, together with filaggrin, are the main protein components of the epidermis (80-90%).
In patients with AD, the function of this protein is abnormal, so that the structure of the epidermis is disturbed. The consequences of this are poor skin hydration and loosening of the connections between epidermal cells, so that the skin doesn’t provide an adequate barrier to allergens, microorganisms and other irritants.
The presence of R501X and 2282del4 mutations in the filaggrin gene has been shown to significantly increase the probability of atopic dermatitis symptoms.
Diagnosis and treatment
The main methods used to diagnose AD are skin and food tests to confirm the presence of an allergic reaction to a particular stimulus. A possible additional test is a skin biopsy.
The first line of treatment for AD is to take antihistamine drugs (such as hydroxyzine) and apply a moist layer of gauze. It is also important to take daily care of the skin and keep it moisturised to restore and maintain the normal state of the skin barrier. It is also advisable to avoid irritants such as synthetic and woollen clothing, hot water and strong detergents and cleansers – the skin’s pH should be maintained at 5.5-6.0.
If symptoms do not persist, see a specialist – an allergologist or dermatologist.
The most common medications used for AD exacerbations are cyclosporine A, topical calcineurin inhibitors and glucocorticosteroids.
Phototherapy is also the standard treatment for AD.
For severe, refractory AD, Azathioprine or Methotrexate is used.
Treatment of AD is extremely strenuous – more than half of patients suffering from AD in childhood, have a relapse in adulthood. Patients also experience long periods of remission, with no current complaints. However, since AD is caused by congenital abnormalities in skin function, the disease can sometimes last even a lifetime.