Atopic Dermatitis

FROM THE ACADEMY

Guidelines of care for the management of atopic dermatitis

Atopic Dermatitis is a chronic, pruritic inflammatory skin disease that occurs most frequently in children, but also affects many adults. It follows a relapsing course. AD is often associated with elevated serum immunoglobulin IgE levels and a personal or family history of type I allergies, allergic rhinitis, and asthma. Atopic eczema is synonymous with AD.

What are the symptoms of eczema?

In the acute state, itching, redness, papules, weeping, scaling and crust formation appear.

In a chronic condition, the main symptoms are itching, redness, scaling, inflammatory thickening of the skin, dryness and cracks in the skin.

What is the effectiveness of non-pharmacologic interventions such as moisturizers, prescription emollient devices, bathing practices and oils, and wet wraps for the treatment of atopic dermatitis?

FROM THE ACADEMY

Guidelines of care for the management of atopic dermatitis

NON PHARMACOLOGIC INTERVENTIONS

Moisturizers

Xerosis is one of the cardinal clinical features of AD and results from a dysfunctional epidermal barrier. Topical moisturizers are used to combat xerosis and transepidermal water loss, with traditional agents containing varying amount of emollient, occlusive and /or humectant ingredients. Although they often include water as well, this only delivers a transient effect, whereas the other components provide the main benefits. Emollients lubricate and soften the skin, occlusive agents form a layer to retard evaporation of water, whereas humectants attract and hold water. Moisturizers can be the main primary treatment for mild disease and should be part of the regimen for moderate and severe disease. They are also an important component of maintenance treatment and prevention of flares. Moisturizers should be included in management plans of AD therapy.

sources: J AM ACAD DERMATOL July 2014 - VOLUME 71, NUMBER 1 - Eichenfield et al