Atopic dermatitis (AD) is a chronic skin disorder. It is characterized by inflammation of the skin that occurs in recurrent flare-ups, alternating periods of improvement with periods of worsening.

causascausasCauses

Causes

AD is caused by different factors in which heredity plays an important role (70% have a family history). Other factors also influence its development, such as industrialized environments, food hypersensitivity (40% of atopic dermatitis cases), infections, etc.

síntomassíntomasSymptoms

Symptoms

We can distinguish typical manifestations of AD according to the patient’s age, including:

  • Infant form (from the first 2–3 months of life up to 2–3 years of age)
  • Childhood form (between 4–10 years)
  • Adult form

The characteristic symptom of AD is itching. It is associated with eczematous-type lesions and generalized dryness.

DiagnósticoDiagnósticoDiagnosis

Diagnosis

The diagnosis of AD is clinical. Sometimes it is necessary to make a differential diagnosis with other skin diseases such as diaper dermatitis (which may be the first manifestation of atopic dermatitis in infants), seborrheic dermatitis, psoriasis, among others.

tratamientostratamientosTreatment

Treatment

The goals of treatment in AD are to reduce the intensity and frequency of flare-ups. To achieve this, we rely on a series of general skin care measures for the atopic child and pharmacological treatment.

General Care:

  • Parents and the atopic patient should receive adequate education about AD.
  • The skin of a child with AD is more susceptible to external irritants such as environmental dryness, synthetic fibers, sweating, infections, etc.
  • Short baths (no more than 5–10 minutes) in lukewarm water are recommended. Use mild "syndet" soaps with pH 5.5. When drying, avoid friction and apply a moisturizer specifically for atopic skin (emollient).
  • In certain cases of AD, bleach baths are recommended under the indication and supervision of a pediatrician and/or dermatologist.
  • It is recommended not to overdress the child and to avoid tight clothing. Use cotton and linen garments that allow the skin to breathe, removing labels and rough surfaces.
  • Keep the child’s nails short and clean to prevent injuries and infections from scratching.
  • Children may bathe in the sea or pool, with rinsing afterward. In children with AD, controlled sun exposure with adequate protection is usually beneficial.
  • Children with AD can eat all foods, except in cases where a proven food allergy is present.

Pharmacological Treatment:

  • Topical corticosteroids are the first choice for the most affected skin areas, used for limited periods of time. Oral corticosteroids are used only occasionally in selected cases.
  • As a complication, lesions may become infected and require topical or even oral antibiotic treatment.
  • Oral antihistamines (never in creams), if necessary, may help reduce itching.
  • Other treatments may be needed depending on the course of the disease. Among them, topical calcineurin inhibitors are used as maintenance therapy between flare-ups.
  • Remember that all these treatments should be evaluated and supervised by a pediatrician and/or dermatologist.
Specialties:
  • Paediatrics