Atopic dermatitis (eczema) is a common inflammatory skin disease that affects approximately 10-20% of children and 1-3% of adults globally. It is a chronic condition that can significantly impact a person's quality of life, causing intense itching, dry and scaly skin, and recurrent skin infections.
Prognosis:
Atopic dermatitis is a chronic condition that can persist for many years, even throughout adulthood. In most cases, symptoms tend to improve with age, with about 60% of children who have the condition experiencing significant improvement by the age of 5. However, about 50% of people with atopic dermatitis will continue to experience symptoms into adulthood. The severity and duration of symptoms can vary widely between individuals, with some experiencing mild symptoms that are easily managed and others experiencing severe symptoms that require ongoing treatment.
Symptoms:
The symptoms of atopic dermatitis can vary widely between individuals and can be influenced by various factors, including age, gender, genetics, and environmental triggers.
Common symptoms include:
Intense itching often becomes severe at night and will impact sleep.
Dry, scaly, or cracked skin can be red or inflamed and develop into small bumps or blisters—skin discoloration, which can be light or dark.
Skin infections can develop when the skin is broken or damaged by scratching.
Thickened, leathery skin can develop in areas of frequent scratching or rubbing.
Diagnosis:
Diagnosis depends on both clinical symptoms and physical examination. No single test can definitively diagnose atopic dermatitis, but doctors may use various tests to rule out other possible conditions.
These tests may include:
The skin patch test involves placing small amounts of potential allergens on the skin to see if they cause a reaction.
A skin biopsy involves removing the skin to examine it under a microscope.
Blood test: This can detect elevated l evels of immunoglobulin E (IgE), indicating an allergic reaction.
Treatment:
The treatment of atopic dermatitis aims to relieve symptoms and prevent flare-ups.
Treatment options may include:
Moisturizers: A thick, fragrance-free moisturizer can help relieve dry skin and reduce itching.
Topical corticosteroids: These medications can reduce inflammation and relieve itching, but they should only be used under the guidance of a doctor and for short periods to avoid side effects.
Crisaborole ointment and ruxolitinib cream is approved for treating atopic dermatitis.
Topical calcineurin inhibitors: These medications can reduce inflammation and itching and are an alternative to topical corticosteroids. Pimecrolimus cream or tacrolimus ointment is commonly used topical calcineurin inhibitors (TCIs) commonly prescribed.
Antihistamines: These are administered to manage itching and improve sleep quality.
In light therapy, the skin is exposed to ultraviolet light, which can help reduce inflammation and improve skin texture.
Immunomodulators: These medications can help modify the immune system response to reduce inflammation and itching.
The other approved FDA drugs are:
Dupixent (dupilumab): It is indicated for the treatment of people of age six months and older who have moderate to severe eczema
Cibinqo (abrocitinib) and Rinvoq (upadacitinib): These are JAK inhibitors indicated for treating atopic dermatitis
Adbry (tralokinumab): It is indicated for treating moderate to severe atopic dermatitis
Atopic dermatitis is common and can significantly impact a person's quality of life. No curative options are available for atopic dermatitis; many treatment options can help relieve symptoms and prevent flare-ups. With proper treatment and management, most people with atopic dermatitis can significantly improve their symptoms and quality of life.