What is Atopic Dermatitis?

April 05, 2022
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Atopic dermatitis (AD) or more often known simply as eczema, is one of the most common dermatological conditions that affects all age groups. This condition is characterized by active inflammation of the skin that causes an array of signs and symptoms.

AD is an autoimmune disease, meaning that immune cells attack skin layers, causing rashes, scaling, itching, and more.

The combination of the high incidence and prevalence with the relapsing nature of AD makes it an extremely challenging condition to deal with.

One interesting fact is that AD is more common in high socioeconomic countries, which may be explained by the hygiene hypothesis.

If you’ve never heard of the hygiene hypothesis, here’s a quick definition:

The hygiene hypothesis is a potential explanation for the elevated incidence of autoimmune diseases in high-income countries.

This hypothesis states that high hygiene standards and the availability of proper medical care (e.g., antibiotics) in wealthy nations lead to the underuse of the immune system.

Consequently, the immune system becomes relatively ‘dormant’, which explains why it overreacts to harmless substances and causes autoimmune diseases, such as AD.

Causes of Atopic Dermatitis

Generally speaking, AD starts during infancy and exhibits an on/off pattern throughout the patient’s life.

Researchers attribute the causes of AD to the ‘nature and nurture’ diagram.

The nature part

As you may know, having a family member with AD increases your risk of developing this condition, which is attributed to the genetic predisposition.

Moreover, AD patients often deal with other allergic and immune pathologies, such as rhino-conjunctivitis, asthma, food allergies, and nasal polyps (i.e. small tissues that form in the nose).

The nurture part

As for the nurture part, it refers to the environmental factors that may trigger the first episode of AD. Usually, this can be the result of a viral infection, a drug, or certain food.

All in all, combining the genetic predisposition with environmental triggers leads to AD.

Signs and Symptoms of Atopic Dermatitis

As with many dermatological conditions, AD presents with a variety of pathological patterns and symptoms that require a trained healthcare professional to identify.

The most common symptoms of AD include:

  • Red-brownish-gray patches all the over body, with a special predilection in the hands, feet, ankles, wrists, neck, and upper chest.
  • Severe urge to itch various parts of the body
  • Dehydrated skin susceptible to UV light damage
  • Cracked skin and raised bumps

Treatment of Atopic Dermatitis

The treatment of AD is a multi-step process that involves educating the patient about the potential triggers of their condition and how to act when AD flares up.

According to the National Eczema Association, the pharmacological drugs used to treat ADinclude:

  • Corticosteroids (first-line) – topical and systemic
  • Systemic anti-inflammatory drugs (e.g., Cyclosporine, Methotrexate)
  • Disease-modifying drugs (Dupilumab, Mycophenolate mofetil)

Sticking to the proper medical management and following your doctor’s instructions may help manage your flareups. In addition, you need to actively self-manage at home to maintain a healthy skin. There are a number of ways to safely self-manage at home, so be sure to ask your doctor for some tips at your next consultation session.

The information herein is not exhaustive and there is more to unpack to help you better understand Atopic Dermatitis. However, we hope this article will help you get one step closer to conquering your condition.

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I have had eczema my whole life - atopic dermatitis, contact dermatitis, dyshidrotic eczema. It is frustrating most of the time but I have been able to manage my flare ups thanks to recommendations from my friends with eczema. I'm here to help others like me get better too!

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