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Dermatitis Treatment - Atopic Dermatitis And Seborrheic Dermatitis

Dermatitis is characterized by inflammation of the skin and can be acute or chronic. It occurs in several forms, including contact, seborrheic, nummular, exfoliative, and stasis dermatitides.

Atopic dermatitis (discussed here), also commonly referred to as atopic or infantile eczema, neurodermatitis constitutionalis, or Besnier's prurigo, is a chronic inflammatory response often associated with other atopic diseases, such as bronchial asthma, allergic rhinitis, and chronic urticaria. It usually develops in infants and toddlers between ages 6 months and 2 years, commonly in those with strong family histories of atopic disease. These children typically acquire other atopic disorders as they grow older. In most cases, this form of dermatitis subsides spontaneously by age 3 and remains in remission until prepuberty (ages 10 to 12), when it flares up again. The disorder affects about 9 out of every 1,000 people.

Causes

Although the exact cause of atopic dermatitis is unknown, several theories attempt to explain its pathogenesis. One theory suggests an underlying metabolically or biochemically induced skin disorder genetically linked to elevated serum immunoglobulin E (lgE) levels. Another theory suggests defective T-cell function.

Atopic dermatitis is exacerbated by certain irritants, infections (commonly Staphylococcus au reus),and allergens. Common allergens include pollen, wool, silk, fur, ointment, detergent, perfume, and certain foods, particularly wheat, milk, and eggs. Flare-ups may occur in response to temperature extremes, humidity, sweating, and stress.

Signs and symptoms

There are several types of dermatitis, including:

  • Contact dermatitis
  • Neurodermatitis
  • Seborrheic dermatitis
  • Stasis dermatitis
  • Atopic dermatitis
  • Perioral dermatitis

Each has distinct signs and symptoms. Common signs and symptoms include redness, swelling, itching and skin lesions.

Diagnostic tests 

Generally, dermatitis is diagnosed clinically, meaning based on the history and appearance of the rash. If possible, the exact type of dermatitis is delineated, but sometimes it is difficult to tell the difference between the dermatitis types. There are very few tests performed that help clarify the type of dermatitis. Some examples of tests that may help with diagnosis are skin tests for contact or atopic dermatitis or a KOH test identifying a fungal infection.

Treatment

Effective treatment of atopic lesions consists of eliminating allergens and avoiding irritants, extreme temperature changes, and other precipitating factors. Local and systemic measures relieve itching and inflammation.

Systemic antihistamines, such as hydroxyzine hydrochloride and diphenhydramine, relieve pruritus, and topical application of a corticosteroid cream, especially after bathing, often alleviates inflammation. A typical medication routine may include a systemic antihistamine, a topical corticosteroid, and a bland emollient. Between steroid doses, application of petroleum jelly can help retain moisture.

Systemic corticosteroid therapy should be used only during extreme exacerbations. Weak tar preparations and ultraviolet B light therapy are used to increase the thickness of the stratum corneum. Antibiotics are appropriate if a bacterial agent has been cultured; antifungal or antiviral medications may be prescribed to fight a fungal or viral infection.

Prevention

Avoid contact with known allergens. Use protective gloves or other barriers if contact with substances is likely or unavoidable. Wash skin surfaces thoroughly after contact with substances. Avoid overtreating skin disorders.

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