23 July 2021 Author : Cristina Claro Atopic eczema or atopic dermatitis is a chronic inflammatory skin disease . It does not manifest in the same way in all people and in the same person the symptoms can vary over time. It may appear for the first time at any age, but in most cases, it starts within the first 5 years of life. Its prevalence has been increasing in recent decades and it is estimated that currently 8%-10% of Portuguese children suffer from atopic eczema. Causes of atopic eczema The cause of atopic eczema is not completely known. Genetic factors seem to play an important role and people with a family history of atopic eczema have an increased risk of developing the disease. In atopic eczema there are structural changes of the outer layer of the skin (epidermis) which becomes more permeable than normal, and this interferes with its barrier function . Thus: There is a greater loss of water through the skin and therefore greater dryness of the skin; Sensitivity to external agents is greater, whether allergic, irritant, or infectious agents. Simultaneously there is an imbalance of the immune system , which more easily develops an inflammatory response to internal or external stimuli. There are also internal and external factors that can trigger or aggravate symptoms . These are variable from person to person and can be, for example: Sweat; Extreme temperatures, whether cold or hot, and sudden temperature changes; Exposure to external factors, such as cleaning products, detergents, cosmetics, dust, tobacco smoke, among others. Symptoms and diagnosis Atopic eczema evolves with periods of crisis alternating with calm periods of variable duration, sometimes of years. The skin is dry and rough and during crisis and there are areas of redness, scaling and crusting; The extent, location and severity of injuries is variable. During crises, it is very typical that the regions of the flexor folds of the limbs are affected. Itching is the dominant symptom, often with great impact on quality of life. Scratching contributes to inflaming the skin and making itching even worse. The skin in areas where lesions previously occurred may become thicker and darker. Eczema symptoms are , however, not the same in all people and in the same person they can vary over time, either in severity or location. The diagnosis of atopic eczema is based on symptoms, history of the disease, family history and physical examination. There is no specific test or analysis to diagnose this eczema. Atopic eczema care and treatment Atopic eczema is a chronic disease with a genetic basis, it cannot be avoided and has no cure. However, there are a variety of daily care and prescription treatments that can be adopted to control symptoms and improve quality of life . Skin general care Maintain an adequate skin hydration. Baths should be brief and with warm water using washing products with moisturizing action, without soap or detergent agents. After bathing, a moisturizing cream for atopic skin should always be applied, which can be reapplied more times a day, as needed to combat dryness; Avoid direct skin contact with wool and synthetic fibers fabrics, prefer cotton clothing; Avoid tight clothing and shoes, prefer those that allow good ventilation and do not cause friction on the skin; Avoid exposure to excessive heat and dry environments with low moisture content; Eliminate objects that may accumulate dust from the environment, such as carpets, soft toys, among others; Keep your nails cut and clean to avoid scratching injuries or infections; Try to minimize emotional stress, which is a factor in atopic eczema. Treatment of crises During crisis, additional intervention is based on treating skin inflammation and controlling itching. For this, medications applied to the affected area (topical medications) are used above all or, if necessary, oral or injectable medications (systemic medications). As a chronic disease, atopic eczema is not necessarily serious and can be effectively managed with proper care and treatment. People with atopic eczema benefit from regular medical surveillance in dermatology for help, advice, and guidance in the treatment of this disease. Meet the dermatology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
