Atopic dermatitis or allergic skin disease (Atopic dermatitis)

Internal disorders not only affect various internal organs, but atopic dermatitis or allergic skin disease is another common problem, mostly caused by internal factors. However, atopic dermatitis or allergic skin disease can also be caused by external factors. Therefore, we should understand it in depth… to reduce the chances of developing this atopic dermatitis.

Common skin diseases are divided into 6 major groups as follows

• Various infections such as viral infections, bacterial infections, fungal infections, and parasitic diseases, etc.
• Eczema dermatitis, divided into 2 groups
• • Endogenous eczema (eczema caused by internal factors)
  • Exogenous eczema (eczema caused by external factors)
• Erythemas, urticaria, various types of drug eruptions
• Papulosquamous diseases such as psoriasis, pityriasis rosea, etc.
• Autoimmune diseases that destroy body tissues such as SLE and bullous pemphigoid group
• Skin malignancy

Understanding… Atopic dermatitis or allergic skin disease (Atopic eczema)

It is a skin disease in the second group where internal factors are important causes of the skin condition, but this does not mean that… skin diseases caused

by external factors have no role in causing symptoms at all, because all diseases develop symptoms due to both internal and external causes and factors affecting the body.

Internal abnormalities or it can be said that these are the genetic characteristics of the patient which are the fundamental factors. Each patient has different genetic traits that are weaknesses or abnormalities inherited from their parents. These inherited defects vary in degree, some more severe and some less, causing patients with atopic dermatitis to show different symptoms and signs with varying severity, ranging from mild, persistent, intermittent, starting in childhood, beginning in adolescence, or some cases starting in adulthood. The key symptoms found in patients with atopic dermatitis are:

1. The skin has less oil in the stratum corneum than normal people
2. Itching occurs more easily than normal and is often worse at night
3. Red rashes appear easily on the skin
4. Scaling or flaking on the skin

Patients with atopic dermatitis often visit doctors with these symptoms..

1. Red itchy rashes in skin folds such as arm folds, leg folds, neck, armpits, groin, and buttock creases
2. Rashes or itchy bumps on both arms and legs, but some cases only on one side
3. White spots or rings on cheeks, arms, legs, or trunk, which may be single or multiple
4. Raised bumps around hair follicles on arms and legs
5. Red or brown itchy rashes on elbows, knees, and neck
6. Red scaly rashes on fingers, toes, palms, or soles
7. Red, dry, flaky lips that come and go

Itching is a major problem causing distress to patients, leading to sleeplessness and irritability. Excessive scratching or picking at the skin worsens the inflammation, causing oozing on the skin, which further spreads the itching all over the body, commonly known as “bad lymph” in local terms.

Other symptoms that may accompany atopic dermatitis include runny nose, cough, intermittent sneezing, or asthma.

Diagnosis of the cause of atopic dermatitis

Diagnosis is based on the history and symptoms mentioned above. Sometimes, family history is also taken into account, often finding that siblings, parents, uncles, aunts, grandparents, or great-grandparents have some form of allergic disease.

Once diagnosed, the doctor will assess the severity of the disease and provide treatment in the following order:

1. Explain atopic dermatitis to the patient and relatives so they understand that the weakness or defect of the skin is a genetic trait that will remain with the patient forever. However, the patient’s body can adapt by exercising, maintaining good health, regularly applying moisturizing lotion according to the weather, and avoiding long hot baths because hot water washes away skin oils. The doctor can control the disease during flare-ups, but long-term management requires the patient and close relatives to help control and adjust behaviors to keep the disease calm or cured in the long term.
2. The doctor will control itching with anti-histamine medication which must be taken continuously until there is no itching for 7 consecutive days before stopping the medication. If itching does not completely disappear with medication, applying a cold compress or moisturizing cream on the skin can help reduce itching.
3. For inflamed, red, or scaly skin, use medium potency steroid creams such as Triamcinolone acetonide 0.1% cream, Betamethasone 17-valerate cream applied twice daily for 7-14 days. If the rash is severe and widespread or if inflammation is severe with oozing on the rash, oral steroids and 0.9% saline solution should be used to clean the oozing. Do not leave oozing on the skin as it causes itching and red bumps to spread all over the body, commonly called “bad lymph”.

If patients follow the above recommendations, the inflamed skin will return to normal quickly. However, these practices also help reduce recurrent eczema rashes. In cases of eczema flare-ups, patients can use appropriate potency steroid creams to help the rash heal faster. We encourage all patients to take care of their atopic dermatitis to heal and minimize or prevent recurrence.