Atopic dermatitis in children

Atopic dermatitis (AD) is a s a common, chronic, inflammatory skin disease characterised by severe itching and dryness of the skin of the whole body. Most often it develops in early childhood, and in a smaller percentage in later childhood and in adulthood. Atopic dermatitis in children can occur very early, even before the 6th week of life in the form of redness, itching and scales on the face and trunk. The distribution and the type of skin lesions associated with atopic dermatitis can vary depending on the age of the child. The dryness of the skin is present during the entire life, and itching and scratching are the most pronounced symptoms of atopic dermatitis. In babies, redness and scales are located on the cheeks and face. These children are irritable, restless, easily awakened to scratch the affected areas. In older infants, redness is localized on the wrists, inner elbows and back of knees. In older children and adults, the skin is dry with traces of scratching, most often around the wrists, the upper side of the foot, the inner elbows and the back of knees.

What causes the development of atopic dermatitis in children?

Atopic dermatitis is a condition with a strongly accentuated genetic component. If one parent suffers from atopic dermatitis, in 60% of cases the condition will also occur in the child, if both parents suffer, in 80% of cases of the child will develop the condition. External factors play an important role in the manifestation of atopic dermatitis. In two thirds of children, atopic dermatitis is resolved by the age of 10, and if the condition developed in infants, it is most often resolved by the age of 5. At a smaller percentage, atopic dermatitis persist throughout patient’s lifetime, with periods of improvement and exacerbation. Atopic dermatitis can be associated with asthma and allergic rhinitis. These individuals genetically have an atopic constitution, which, in the presence of external factors, leads to the manifestation of the condition. Sometimes mistakes in baby skin care can contribute to exacerbation of the condition. These children have extremely dry skin, due to the reduced formation of a lipid barrier film on the surface of the skin that plays a protective role. Since there is already a decrease in the lipid film, any additional drying of the skin, using aggressive soaps and baths contributes to the exacerbation of the disease. It is advised to avoid wool clothing and other irritants, such as strong laundry detergents and softeners. Children should not be layered with too much clothes, because the sweating also irritates the skin. Household dust and mites should be eliminated by avoiding carpets, heavy curtains while using the vacuumed bedding.

How is atopic dermatitis treated?

In the treatment of atopic dermatitis, the overall skin care of a child is important, which contributes to the resolution of the condition. It is necessary to use emollient creams that compensate for the lack of lipids and dryness on the skin surface. Nevertheless, they will be necessary sometimes, but for short period of time. The skin of these children is often populated by bacteria, contributing to the exacerbation of the condition, so it is necessary to eliminate them with topical antibiotics. With persistent and long-lasting eczema, excellent results are achieved by topical application of immunomodulatory creams.
Autor
Svetlana Đurišić specijalista dermatovenerologije

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