Handout on Health: Atopic Dermatitis – Arthritis …

May 2013

This publication is for people who have atopic dermatitis (often called eczema), parents and caregivers ofchildren with atopic dermatitis, and others interested in learning more about the disease. The publicationdescribes the disease and its symptoms and contains information about diagnosis and treatment, as well as current research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the U.S. Department of Health and Human Services National Institutes of Health (NIH). It also discusses issues such as skin care and quality of life for people with atopic dermatitis. If you have further questions after reading this publication, you may wish to discuss them with your doctor or your childs pediatrician.

Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. It is not contagious; it cannot be passed from one person to another. The word dermatitis means inflammation of the skin. Atopic refers to a group of diseases in which there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever. In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, weeping clear fluid, and finally, crusting and scaling. In most cases, there are periods of time when the disease is worse (called exacerbations or flares) followed by periods when the skin improves or clears up entirely (called remissions). As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, although their skin often remains dry and easily irritated. In others, atopic dermatitis continues to be a significant problem in adulthood.

Atopic dermatitis is often referred to as eczema, which is a general term for the several types of inflammation of the skin. Atopic dermatitis is the most common of the many types of eczema. Several have very similar symptoms. Types of eczema are described in the box below.

Atopic dermatitis is very common. It occurs equally in males and females and affects an estimated 9 to 30 percent of people in the United States. Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood. Onset after age 30 is less common and is often caused by exposure of the skin to harsh or wet conditions. People who live in cities and in dry climates appear more likely to develop this condition.

The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors.

Children are more likely to develop this disorder if a parent has had it or another atopic disease like asthma or hay fever. If both parents have an atopic disease, the likelihood increases. Although some people outgrow skin symptoms, approximately half of children with atopic dermatitis go on to develop hay fever or asthma. Environmental factors can bring on symptoms of atopic dermatitis at any time in affected individuals.

Atopic dermatitis is also associated with malfunction of the bodys immune system: the system that recognizes and helps fight bacteria and viruses that invade the body. The immune system can become misguided and create inflammation in the skin, even in the absence of a major infection. This can be viewed as a form of autoimmunity, where a body reacts against its own tissues.

In the past, doctors thought that atopic dermatitis was caused by an emotional disorder. We now know that emotional factors, such as stress, can make the condition worse, but they do not cause the disease.

Symptoms (signs) vary from person to person. The most common symptoms are dry, itchy skin and rashes on the face, inside the elbows and behind the knees, and on the hands and feet. Itching is the most important symptom of atopic dermatitis. Scratching and rubbing in response to itching irritates the skin, increases inflammation, and actually increases itchiness. Itching is a particular problem during sleep when conscious control of scratching is lost.

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Handout on Health: Atopic Dermatitis - Arthritis ...