Atopic dermatitis: Risk, symptoms and management
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease causing itchiness. It is characterized by a damaged skin barrier, a skin inflammation, and an imbalanced skin microbiome. As for the visible signs, redness, erythema and scaly patches are most common. Even in patients with a typical distribution and morphology of lesions, the appearance of AD varies based on skin colour. Erythema in darker skin is more likely to appear violaceous or may be missed completely.
RISK FACTORS
SYMPTOMS
LOCALIZATION
INFANTS UP TO 2 Y.O
cheeks and chin, stomach, arms, hands, wrists, legs, ankles
CHILDREN
face, wrists, hands, knees, ankles
ADULTS
eyelids, face, neck, palms, fingers
cheeks and chin, stomach, arms, hands, wrists, legs, ankles
CHILDREN
face, wrists, hands, knees, ankles
ADULTS
eyelids, face, neck, palms, fingers
IMPACT ON QUALITY OF LIFE
IN CHILDREN
- 9/10 suffer from itching at night
- 43% suffer from attention deficit, hyperactivity disorders
- Social stigmatization, bullying, tendency to stay alone
Camfferman et al. Eczema and sleep and its relationship to daytime functioning in children.2010. Sleep Med rev. 14(6)359-69
Silverberg. Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric and musculoskeletal associations. 2017. Clin. Dermatol. 35(4):360-366
Chang & Ciang. 2016. Mechanism of sleep disturbance in children with atopic dermatitis and the role of the circadian rhythm and melatonin. Int J Mol Sci. 17(4):462
Silverberg. Selected comorbidities of atopic dermatitis: atopy, neuropsychiatric and musculoskeletal associations. 2017. Clin. Dermatol. 35(4):360-366
Chang & Ciang. 2016. Mechanism of sleep disturbance in children with atopic dermatitis and the role of the circadian rhythm and melatonin. Int J Mol Sci. 17(4):462
IN ADULTS
- 57% miss at least one day of work and have:
- Problems with intimacy
- Feelings of guilt
1. Ring J, Zink A, Arents B, Seitz I, Mensing U, Schielein M, et al. Atopic eczema: burden of disease and individual suffering – results from a large EU- Study in adults. J Eur Acad Dermatol Venereol 2019; 33: 1331–1340.
ATOPIC DERMATITIS MANAGEMENT
AD is a vicious cycle with alternating flare-ups (increased itch and pain) and periods of remission.
Right maintenance care spaces out flare-ups and improves qualtity of life.
Right maintenance care spaces out flare-ups and improves qualtity of life.
MAINTENANCE CARE
CLEANSING
Mild cleansing product: non-irritant, soap-free, without perfume and pH =5.5 (type SYNDET)
HYDRATING
Emollient or Emollient plus enriched with active ingredients
FREQUENCY OF APPLICATION
At least once a day, after shower in the morning or at night
Consider one other time during the day
Mild cleansing product: non-irritant, soap-free, without perfume and pH =5.5 (type SYNDET)
- To remove crusts of the skin
- To eliminate bacterial contaminants
HYDRATING
Emollient or Emollient plus enriched with active ingredients
- To relief the symptoms: dry skin, itch, tingling and burning sensation
FREQUENCY OF APPLICATION
At least once a day, after shower in the morning or at night
Consider one other time during the day
Moncrieff G, Lied-Lied A, Nelson G, Holy CE, Weinstein R, Wei D, et al. Cost and effectiveness of prescribing emollient therapy for atopic eczema in UK primary care in children and adults: a large retrospective analysis of the Clinical Practice Research Datalink. BMC Dermatol. 2018 Oct 29;18(1):9.
FLARE-UP TREATMENT
- Use daily cleanser and hydration
- Apply medicated topical creams to areas of readness and irritation, as prescribed by healthcare professional
DAILY TIPS
