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 face.2 The skin barrier plays an important role in eczema, in eczematic skin the skin barrier can be easily aggravated and compromised by irritants such as soaps, creams, detergents and bacteria.3
Treatment for atopic eczema can help to relieve the symptoms and many cases improve over time.1 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 mentally.1 Chronic itching can have a huge impact on patients quality of life, causing lack of sleep and time off work and school.4 Consequently this can have an effect on self-confidence, mood and relationships.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 annum.5 This can mean lack of sleep, and time off work or school, with effects on self-confidence, mood and relationships.5
Physical burden: AD is characterised by the presence of dry, red, itchy and inflamed skin which may crack.1,2 In children it normally presents on the face and flexural areas of the arms and legs.4
Emotional burden: AD can severely impact patients’ lives by affecting psychological well being and social functioning restricting quality of sleep, everyday activity and requiring time off work.5 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 mentally.1 However there are a number of treatments which may control the symptoms and help manage the disease.1
The pathophysiology of atopic dermatitis is quite complex including immune deviation and skin barrier dysfunction.2 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 accordingly.6
- NHS. Atopic Eczema. Available at: https://www.nhs.uk/conditions/atopic-eczema/ Last accessed: June 2019
- Weidinger, S. Lancet 2016; 387(10023): 1109-112
- Cork MJ, J invest Dermatol. 2009; 129(8)
- LifschitzC. Ann NutrMetab2015; 66:34-40
- ZuberbierT, et al. J Allergy Clin Immunol 2006; 118:226–232.
- NICE Pathways – Atopic Dermatitis. https://pathways.nice.org.uk/pathways/eczema#path=view%3A/pathways/eczema/treating-atopic-eczema-in-children-aged-12-and-under.xml&content=view-node%3Anodes-stepped-approach-to-treatment (last accessed May 2019)