What is atopic dermatitis?
Atopic dermatitis (AD) is the most common form of eczema, a chronic, inflammatory skin condition that causes the skin to become itchy, red, dry and cracked.1,2
Atopic dermatitis can affect any part of the body, however, it most often affects the insides of the elbows, back of the knees and the face2. The skin barrier plays an important role in eczema, in healthy skin with a resilient barrier, irritants like house mites, soaps, creams, detergents and bacteria cannot get through the skin3. Treatment for atopic eczema can help to relieve the symptoms and many cases improve over time1. However, there’s currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally1. Chronic itching can have a huge impact on patients quality of life, causing lack of sleep and time off work and school4. Consequently this can have an effect on self-confidence, mood and relationships however, if symptoms are properly managed patients are able to lead normal lives.4
What is the impact of atopic dermatitis?
A study with over 2000 patients has shown moderate to severe patients can experience around nine ‘flare ups’ per annum5. This can mean lack of sleep, and time off work or school, with effects on self-confidence, mood and relationships5. If AD is properly managed, the disease symptoms can be kept under control and patients are able to lead normal lives.4
AD is characterised by the presence of dry, red, itchy and inflamed skin which can become scaly. It normally presents on the face and flexural areas of the arms and legs.4
AD can severely impact patients’ lives by affecting psychological well being and social functioning restricting quality of sleep, everyday activity and requiring time off work5. Furthermore, 75% of caregivers and patients feel that being able to effectively control AD would be the single most important improvement to their or their child’s quality of life.5
How to diagnose and treat atopic dermatitis?
As a chronic condition, atopic dermatitis often has a significant impact on daily life, which may be difficult to cope with physically and mentally1. However certain treatments can be used to control the symptoms and manage the disease.1
The pathophysiology of atopic dermatitis is quite complex including immune deviation and skin barrier dysfunction2. Treatment for atopic dermatitis is dependent on disease severity and includes basic therapy with emollients and avoidance of symptom triggers1. National Institute for Health and Care Excellence (NICE) recommends a stepped approach to treatment – this means tailoring the treatment step to the severity of the symptoms. Management can then be stepped up or stepped down accordingly6. For Sweden see https://lakemedelsverket.se/ or regional guidelines.
- https://www.nhs.uk/conditions/atopic-eczema/. Last accessed May 2019.
- Weidinger, S. Lancet 2016; 387(10023): 1109-112 3. Cork MJ, J invest Dermatol. 2009; 129(8)
- Emerson RM, et al. Br J Dermatol 1998; 139:73–76
- LifschitzC. Ann NutrMetab2015; 66:34-40
- ZuberbierT, et al. J Allergy Clin Immunol 2006; 118:226–232.
- https://pathways.nice.org.uk/pathways/eczema#path=view%3A/pathways/eczema/treating-atopic-eczemainchildren-aged-12-and-under.xml&content=view-node%3Anodes-stepped-approach-to-treatment (last accessed May 2019)