11 February 2020 What is atopic dermatitis or atopic eczema? Atopic dermatitis is an inflammatory skin disease, characterized by skin dryness , peeling and itching . Its location varies with age: In the infant it appears on the face, trunk and abdomen; In early childhood and adolescence it appears on the folds of the arms, legs (behind the knees), as well as on the eyelids and around the mouth; In adults it can be generalized, on the back of the neck or predominant in the hands. Atopic dermatitis is more common in children and usually has a good prognosis, improving until the adolescence. When it persists until adulthood or appears for the first time in this age group it tends to be more severe. What causes atopic dermatitis? The cause of atopic dermatitis is multifactorial, that is, it results from the interaction of several factors , both related to the individual and the environment. Concerning individual factors , genetic disorders stand out, usually in patients with more severe atopic dermatitis, and tendency to have food and respiratory allergies. Environmental factors include stress, pollution and the tendency to have infections with specific types of bacteria that can aggravate atopic dermatitis. How is the diagnosis of atopic dermatitis made? The diagnosis of this disease is essentially clinical . In most cases, the clinical history and the lesions observation allows to formulate a diagnosis. Sometimes when the lesions do not improve with treatment or when there are doubts in the diagnosis it is necessary to perform a skin biopsy. Allergy tests , such as skin tests or blood tests for allergies, help to understand whether the patient with atopic dermatitis also has a food or a respiratory allergy, thus helping to guide treatment . How is atopic dermatitis treated? The first line treatment is the use of moisturizing creams . Then it may be necessary to use creams or ointments that reduce skin inflammation (with topical corticosteroids and immunomodulators). In acute periods, it may be necessary to take oral corticosteroids (tablets) for a short period of time. In severe cases, immunosuppressive drugs (tablets that generally reduce inflammation) can be an option. In few cases, there may even be indication for medicines called “biological” , that are available only for hospital prescription. The authors of this text are the following allergologists from the Hospital da Luz network: Luís Miguel Borrego, Ana Morais Mendes, Ana Reis Ferreira, Andreia Ferrão, Carlos Braga, Cristina Lopes, Diana Pereira da Silva, Filipa Semedo, Isabel Costa Silva, João Gaspar Marques, Pedro Carreiro Martins, Marta Salgado, Nuno Sousa, Rosa Anita Fernandes, Susana Piedade 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.
