Atopic dermatitis: also known as atopic or infantile
eczema. – a superficial inflammatory process involving primarily
the epidermis, marked early by redness, itching, minute papules and vesicles,
weeping, oozing, and crusting, and later by scaling, lichenification and
Atopic dermatitis refers to a chronic inflammatory response of the
skin. It’s frequently associated with other atopic diseases, such
as bronchial asthma, allergic rhinitis, and chronic urticaria.
Atopic dermatitis usually develops in infants between ages 1 year, commonly
in those with strong family histories of atopic disease. These children
often acquire other atopic disorders as they grow older. Usually,
dermatitis subsides spontaneously by age 3 and stays in remission until
prepuberty – ages 10 to 12, when it frequently flares up again.
Cause: There are several theories to attempt to explain
its pathogenesis (true caused is unknown). One theory suggests an
underlying metabolically or biochemically induced skin disorder genetically
linked to elevated serum IgE levels. Another suggests defective T-cell
Exacerbating factors of atopic dermatitis include irritants, infections,
and some allergens, including pollen, wool, silk, fur, ointments, and eggs.
Flare-ups may occur in response to extremes in temperature and humidity,
sweating, and stress.
Intensely pruitic (itching), redness, often excoriated, maculopapular
rash, usually on the face and antecubital and popliteal areas.
May have oozing, crusting, and later by scaling, lichenification (thickening
and hardening of the skin) and often pigmentation.
Effective measures against atopic lesions include eliminating allergens
and avoiding irritants, extreme temperature changes, and other precipitating
Topical application of a corticosteroid cream or ointment, especially
after bathing, frequently alleviates inflammation.
Between steroid doses, application of petrolatum can help retain moisture.
Systemic cortiosteroid therapy should be used only during extreme exacerbations.
Weak tar preparations and ultraviolet B light therapy are used to increase
the thickness of the stratum corneum.
If a bacterial agent has been cultured, the doctor may order and antibiotic.
Patient teaching: bathe daily by soaking in plain
water for 10 to 20 minutes.
Bathe with a special nonfatty soap and tepid water but to use soap only
on areas that need cleaning when bathing is finished. (soaking cleans
most skin surfaces).
Shampoo frequently and apply a topical corticosteroid afterward.
Keep fingernails short to limit excoriation and secondary infections
caused by scratching.
Lubricate skin after a tub bath
Irritants, such as detergents, wool, and emotional stress, exacerbate