Atopic dermatitis is an inflammatory skin condition that creates a feeling of intense pruritus (itching), with chronic evolution. Atopic dermatitis typically affects early childhood but can occur at all ages. 60% of cases occur before the first year of life and up to 85% of cases, starts up to five years.
It is estimated that 10-20% of children and 1-3% of adults suffer from atopic dermatitis and the disease prevalence is growing especially in developing countries.
Atopic dermatitis - the cause and mechanism
Atopic dermatitis is considered a multifactorial disease, whose clinical expression depends on complex interactions:
hereditary predisposition (70% of patients have a family history of atopy)
functionally impaired skin barrier (because of epidermal lipid metabolism disorders)
a series of triggers or aggravating factors of skin lesions
Among the factors that can cause atopic dermatitis, most often are prosecuted:
dietary factors - cow's milk, eggs, peanuts, peanut, soybean, wheat, fish, seafood
aeroalergeni - house dust mites
infectious agents - Staphylococcus aureus, oval Pytirosporum
contact factors - cleaning agents containing alcohol, which dries the skin (astringent), perfumes, detergents and harsh soaps
tight and abrasive wear wool or synthetic materials
physical factors - extreme temperatures
Atopic dermatitis - clinical manifestations
Primary and predominant symptom of atopic dermatitis is pruritus (macarime) that often triggers a vicious circle: itching leads to scratching (scratching), skin scraping to determine changes in the end will reduce the threshold of sensitivity to stimuli (skin hyperreactivity) that trigger itching triggered again, the itching sensation. In children, itching in determining fecvent intrerurperi night's sleep, marked irritability secondary insomnia due to itching sensation.
Dry skin is a clinical feature (xerotice).
Clinical manifestations of atopic dermatitis are variable, and their appearance and distribution of lesions that are dependent on age. Thus, we describe three phases of atopic dermatitis:
infant (between 2 months and 2 years) that are of acute injuries (papulovezicule and zemuinde areas), located mainly in the head (scalp, cheeks), neck, trunk and extremities face extension
childhood (between 4 and 10 years of age), in which lesions are less acute and less humid areas are often located in flexors (folds of neck, elbow, knee, wrist). Papules are frequently dry, excoriation, lichenification, erythema and swelling around the eyes
adolescents and adults - the lesions are mainly dry plates, lichenificate, hyperpigmented areas located in and around the eyes flexion