Atopic dermatitis (Eczema): Symptoms, causes, triggers and treatments (dermatology lectures).

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Eczema, or dermatitis, is a group of conditions characterized by inflammation of the skin. Among the many types of dermatitis, the most common is atopic dermatitis, also known as atopic eczema. Very often, when not specified otherwise, the term “eczema” is used to describe the atopic type.
Symptoms of atopic dermatitis include rashes, redness, scaling, and occasionally small blisters. Depending on the patient’s age, these patches may appear on the face, scalp, neck, inside the elbows, behind the knees, on the buttocks, hands and feet. The condition evolves in the form of recurrent inflammatory flare-ups followed by periods of remission. Flare ups can be triggered upon contact with irritants such as soap, detergents, rough fabric or certain foods. A dry atmosphere, changes in temperature, dental eruptions and stress are also common triggers. Over time, the skin can become thickened, bumpy and constantly itch, even when the inflammation is not flaring up. Atopic eczema usually starts in early childhood and MAY last into adult life. Most children outgrow the disease with age but their skin may remain dry and easily irritable.
Atopic dermatitis is an allergic disease. The cause is unknown but it is likely to involve genetic and environmental factors. Atopic eczema often runs in families whose members also tend to develop hay fever, asthma and certain food allergies. Most notable is the gene that encodes for filaggrin, a protein involved in water retention and is responsible for the skin barrier function. Mutations in the filaggrin gene cause dry skin and, as a result, a strong susceptibility to the disease. Eczema is NOT contagious.
There is no cure for atopic dermatitis. Treatments aim to relieve symptoms, reduce frequency of flare ups and prevent skin infection. A treatment plan may include:
- Lifestyle changes: bathe at least once a day but avoid soaps; wear silk clothing and avoid wool; avoid allergy triggers.
- Skincare: use oil-based, fragrance-free moisturizers to keep the skin hydrated during remissions.
- Medications: anti-inflammatory drugs such as steroid creams can be used during flare-ups. Antibiotics may be required if skin infection occurs.

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