Atopic Dermitatis

Atopic Dermitatis
intro
 known as atopic eczema, is a long-term type of inflammation of the skin.

 is more common in younger children.
 In people with Atiopc Dermatitis, for complex, the immune system becomes
disordered and overactive.
 This triggers inflammation that damages the skin barrier, leaving it dry and prone
to itching and rashes that may appear purple, brown or grayish hue in darker skin
tones and red in lighter skin tones.
 Can be caused due to deficiency.
Symptoms
 Atopic dermatitis (eczema) symptoms can appear anywhere on the body and vary widely
from person to person. They may include:
 Dry, cracked skin
 Itchiness (pruritus)
 Rash on swollen skin that varies in color depending on your skin color
 Small, raised bumps, on brown or Black skin
 Oozing and crusting
 Thickened skin
 Darkening of the skin around the eyes
 Raw, sensitive skin from scratching
 Atopic dermatitis often begins before age 5 and may continue into the teen and adult years.
For some people, it flares and then clears up for a time, even for several years.
Causes
 In some people, atopic dermatitis is related to a gene variation that affects the
skin's ability to provide protection. With a weak barrier function, the skin is less
able to retain moisture and protect against bacteria, irritants, allergens and
environmental factors — such as tobacco smoke.
 In other people, atopic dermatitis is caused by too much of the bacteria
Staphylococcus aureus on the skin. This displaces helpful bacteria and disrupts
the skin's barrier function.
 A weak skin barrier(due to vitamin D deficiency) function might also trigger an
immune system response that causes the inflamed skin and other symptoms.
 Atopic dermatitis (eczema) is one of several types of dermatitis. Other common
types are contact dermatitis and seborrheic dermatitis (dandruff). Dermatitis isn't
contagious
Diagnosis
 To diagnose atopic dermatitis, health care provider will likely talk about your
symptoms, examine skin and review medical history. May need tests to identify
allergies and rule out other skin diseases.
 Patch testing
 Doctor may recommend patch testing on skin. In this test, small amounts of
different substances are applied to skin and then covered. During visits over the
next few days, the doctor looks at skin for signs of a reaction. Patch testing can
help diagnose specific types of allergies causing your dermatitis.
Treatment
 may start with regular moisturizing and other self-care habits

 If these don't help, your health care provider might suggest medicated creams that
control itching and help repair skin
Medications
 Many options are available to help control itching and repair the skin. Products
are available in various strengths and as creams, gels and ointments.
 Drugs to fight infection. Your health care provider may prescribe antibiotic pills to
treat an infection.
 Pills that control inflammation. For more-severe eczema, your health care
provider may prescribe pills to help control your symptoms.
 Wet dressings involves applying a corticosteroid ointment and sealing in the
medication with a wrap of wet gauze topped with a layer of dry gauze.
 Light therapy. This treatment is used for people who either don't get better with
topical treatments or rapidly flare again after treatment. Though effective, long-
term light therapy has harmful effects, including premature skin aging, changes in
skin color (hyperpigmentation) and an increased risk of skin cancer.
 Relaxation, behavior modification and biofeedback. These approaches may help
people who scratch out of habit.
Case study
 A 12-year-old obese African American boy with a history of atopic dermatitis

presented to the emergency department with a history of increasing lower
extremity pruritus and edema. He recently had been treated with a 10-day course
of oral clindamycin for infected atopic dermatitis of the legs, with minimal
response. His symptoms had worsened in the 2 days preceding this visit. He
denied fever, cough, shortness of breath and insect bites. His past medical history
is remarkable for severe atopic dermatitis and intellectual disabilities.
 His left leg, left ankle at the lateral malleolus and left foot were swollen and
erythematous, with open, foul-smelling lesions, and are tender to palpation.
 test results showed a white blood cell count of 8,400/µL. Radiographs of the left
lower extremity showed soft-tissue swelling.
 the patient was remarkable for hyperpigmented patches with lichenification of the skin of both
legs. The left leg was warm and tender from the dorsal foot up to the lower calf, including the
left lateral malleolus. Drainage of a yellowish, serosanguineous and malodorous fluid was
noted.
 Two days later, umbilicated vesicles and a number of lesions with a punched-out appearance —
the characteristic lesions of eczema herpeticum — developed on top of the lichenified skin
typical of atopic dermatitis .
 The results of viral culture, which grew herpes simplex virus (HSV), and bacterial culture of
the open lower extremity wounds, which grew Staphylococcus aureus and Escherichia coli,
confirmed the diagnosis: This patient with severe atopic dermatitis also had eczema herpeticum
along with a superimposed bacterial infection.
 After consultation, the infectious disease specialist recommended treatment with ciprofloxacin,
vancomycin and rifampicin. The dermatologist recommended acyclovir therapy for the
comorbid eczema herpeticum, plus topical emollient cream for improving the skin lesions and
lichenification.
References
 Mohr SB. A brief history of vitamin D and cancer prevention. Ann Epidemiol.
2009
 Palm T. The geographical distribution and etiology of rickets. The Practioner.
1890
 Eichenfield LF, et al. Current guidelines for the evaluation and management of
atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and
American Academy of Dermatology guidelines. Journal of Allergy and Clinical
Immunology; 2017
 Stander S. Atopic dermatitis. The New England Journal of Medicine. 2021
 American Academy of Dermatology Guidelines: Awareness of comorbidities
associated with atopic dermatitis in adults. Journal of the American Academy of
Dermatology. 2022

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Atopic Dermitatis

 known as atopic eczema, is a long-term type of inflammation of the skin.

 may start with regular moisturizing and other self-care habits

 A 12-year-old obese African American boy with a history of atopic dermatitis

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