Eczema (Atopic Dermatitis)
Eczema, also called atopic dermatitis, is a common chronic skin condition in children as well as adults. It is especially common in infants and young children and in fact is the most common chronic skin condition in children with a lifetime prevalence of 17%. It starts before the age of 5 years approximately 90% of the time. Symptoms include itching and thickened, red skin on many parts of the body. It tends to affect the face and outside of the arms in infants and young children. In adults, the inner part of the elbow as well as the area behind the knee is frequently involved. It may be very mild or very severe, especially in young children.
Eczema is associated with a dysfunction of the skin barrier, causing excessive water loss from the skin. There is also a defect in the production of substances in the skin that fight infections, which results in frequent infections with Staph bacteria as well as occasional infections with other organisms such as the herpes virus.
Eczema is frequently associated with allergies. In infants and young children with severe eczema, foods allergies may make the eczema worse. Allergens in the air, such as cat and dog allergen may also make eczema worse. Infants and young children with eczema are at increased risk of developing asthma.
The treatment of eczema requires a comprehensive management plan with attention to patient education. Skin testing to look for allergic triggers is frequently needed. Components of therapy include avoidance of triggers, skin hydration by bathing and moisturizing, anti-inflammatory medication, and treatment of underlying infections. There are also a number of other treatment options for severe eczema.