Atopic dermatitis in infants and children Custom Search Dermatitis refers to inflammation of the skin. Atopy is derived from Greek and means special or unusual. In medicine the word atopy is used to denote genetic tendency to develop allergic diseases such as atopic dermatitis, asthma and allergic rhinitis. Patients of atopy usually produce excessive amounts of a particular type of antibody called IgE. Atopic dermatitis is common all over the world. Patients suffering from atopic dermatitis suffer from severe itching of skin. The skin becomes red. There may be dryness of skin with scaling. The condition usually starts in early infancy. The affected baby may cry incessantly due to itching. Older babies start scratching which leads to abrasions, oozing and often secondary infection. The areas commonly affected are face, back of knees, elbows and wrists. In infants the face is commonly involved. In older children back of knees and elbows are commonly affected. In some children only the soles may be involved manifesting as fissures, redness and pain. When the problem persists for long time there may be thickening of skin with prominent creases a process known as lichenification. The condition often has an intermittent course with remissions and relapses. It usually subsides by teenage but in a small percentage may persist into adulthood. The exact cause of this disease is not known. Genetic predisposition may play a role as family history of the disease is common. The condition worsens in extremes of climate (very hot and very cold climate). Low humidity also aggravates the condition. Use of alkaline soap and synthetic material used for clothing may also contribute to the disease. Treatment: it may be necessary to continue treatment for several months or even years. Treatment consists of avoidance of aggravating factors, use of moisturizers and judicious use of local steroids. It is better to use lukewarm water for bathing. Hot water may cause irritation. After bathing body should be dried by gently patting. Rubbing of skin should be avoided. For those children who do not tolerate water Cetaphil lotion may be used for cleaning the skin. A moisturizing cream should be applied immediately. This prevents drying and irritation. Cotton clothes should be used. Antihistamines may be used if itching is severe. For more severely affected children local steroids may be used for a short period. Only low to medium potency steroids should be used as high potency steroids cause many adverse effects. Any infection of the skin should be promptly treated. Room humidifier may be helpful in those areas with low atmospheric humidity. Most of the children can be successfully managed with the above treatment. For those who do not respond topical anti-inflammatory drugs are available. Pimecrolimus or Tacrolimus may be used in older infants who do not respond to the above treatment. These preparations may cause burning sensation. They may also slightly increase the risk of bacterial and viral infections of the skin. Custom Search
Page last reviewed on 28th June 2010
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