Atopic Dermatitis

Importance of Patient Education

Submitted by Garibyan_Huang
on Wed, 10/31/2012 - 5:29pm

We learned from our last blog posting that eczema is a chronic disease.  Unfortunately there is no magic pill or treatment for chronic diseases, and there is no cure. Patients with any type of chronic disease learn about lifetime management of the symptoms associated with their disease. Therefore, chronic diseases need long lasting management plans tailored for each individual patient for the disease state that they are in.

We are fortunate that novel research in the area of atopic dermatitis has led to the discovery of many new management approaches, drugs and regimens.

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Atopic Dermatitis
Alternatives

National Jewish Health Receives Grant to Provide Atopic Dermatitis Education to Denver Pediatric Clinics

National Jewish Health (NJH) has received an educational grant from GlaxoSmithKline (GSK) to improve the care of pediatric patients with atopic dermatitis in a medically underserved population. The one-year $586,511 independent medical educational program grant from GSK will be used by NJH to train health care providers and team members from Rocky Mountain Youth Clinics (RMYC) to better diagnose and manage their atopic dermatitis patients, and ultimately improve patient care and quality of life in the Denver metropolitan area.

“Undiagnosed and untreated atopic dermatitis can have a crippling

The Persistence of Atopic Dermatitis and Filaggrin (FLG) Mutations in a US Longitudinal Cohort

Since the beginning of this century several studies have been published that have helped to revolutionize our understanding of the pathophysiology of AD. These studies have shown an association between genetic variation and AD.  Genes that have been implicated include genes that code proteins associated with skin barrier and genes that code proteins involved in immune function.

How often should I be applying topical steroids?

Q:  How often should I be applying topical steroids?

A:  Topical corticosteroids are a mainstay of eczema therapy. Sadly, results are often suboptimal because of steroid phobia and mistakes in applying the steroids. The drugs are safe if we focus on two crucial factors: Frequency and Duration.

Here are some suggestions for proper use of topical corticosteroids:
* Apply to hydrated skin (after bath, shower or wet compresses).
* Generally speaking, and based on your doctor’s directions, begin with twice daily applications for durations of NO more than 3 days for face, eyelids, neck and folds 7 to

What do I need to know to use topical steroids correctly?

Q:  Sometimes I don’t follow my doctor’s directions concerning my eczema and steroid medications. What do I need to know to use topical steroids correctly?

A:  Managing eczema is confusing; details are important. Doctors complain that patients don’t follow advice. Probably just as often, patients don’t understand what was advised. It’s best to plan a follow-up visit one to two weeks after a steroid is prescribed to clarify instructions and enhance control of eczema if possible. Ask questions and demand clear answers.

Here are some common mistakes to be aware of in topical steroid therapy:
* Not

What causes a person to get eczema on his or her body?

Q:   What causes a person to get eczema on his or her body? How can the terrible itch be helped? Are they working on a cure for this awful stuff?

A:   Atopic dermatitis is the most common type of eczema and has a genetic basis. Recently discovered genetic defects in the skin barrier seem to account for many, if not most, cases. The defective barrier allows chemical and physical irritants and bacterial toxins to trigger inflammation that causes redness and itching.

What is the Contact Allergen Replacement Database (CARD)?

Q:   What is the Contact Allergen Replacement Database (CARD)? And can I gain access to it without a physician?

A:   CARD and CAMP (Contact Allergen Management Program) are databases that can suggest personal care products free of specified allergens.
It is impossible for patients or physicians to accurately diagnosis allergic contact dermatitis to the specific components of items that touch the skin without patch testing. Therefore, access to these databases is restricted to patients who have undergone patch testing by a dermatologist.

What is the best information I can provide my doctor with?

Q:  What is the best information I can provide my doctor when I have my appointment?

A:  Describe environmental factors (season, skin care products, antibiotics, etc.) that make your eczema better or worse.

What is the wet-dry cycle?

Q:  What is the wet-dry cycle, and why is it bad for eczema?

A:  The wet-dry cycle refers to the drying of skin dampened with water or perspiration. Imagine a muddy field: if the sun dries the field quickly, the mud cracks; if it dries slowly on a cloudy day the mud stays smooth. Skin with eczema is especially likely to crack in low humidity conditions when it dries quickly. Applying a moisturizer to slow the drying of wet skin is therefore especially important in the winter when the humidity is lower.

What are allergens?

Q:  What are allergens, and what are the most common allergens that aggravate eczema?


A:  Allergens are any molecule in the environment that can penetrate skin and cause an inflammatory response. Most allergens cause a rash in only a small number of people, but some like poison ivy cause a rash in most people who have skin contact with it. Allergic contact dermatitis usually develops to small, non-protein molecules such as preservatives or metals. Atopic dermatitis patients can also develop contact dermatitis to plant proteins such as oat or dandelion.

What is the difference between atopic dermatitis and contact dermatitis?

Q:  What is the difference between atopic dermatitis and contact dermatitis?

A:  Atopic dermatitis appears early in life as chapped skin in areas that go through frequent wet-dry cycles (for example, the area around the mouth in babies) or in skin folds. Atopic dermatitis patients are susceptible to skin infections, which often make inflammation worse. Protein molecules, such as foods, or pollen or latex can penetrate broken and inflamed skin, and atopic patients are especially likely to develop an immune response to these types of allergens.

Allergic to Chloramine

Dear NEA Scratch Pad:

Several years ago, I was diagnosed with atopic dermatitis. The photo shows the rashes on my back, and there were similar rashes on most of the rest of my body. Fortunately I discovered that the problem was chloramine, a mixture of ammonia and chlorine that is used to disinfect the tap water in many areas of the United States (including the San Francisco Bay area, where I live). After I stopped using our water, my skin cleared up completely. I’m sure there are folks with similar problems who are not aware of this chemical and are suffering as a result.

Beeswax and Olive or Almond Oil

Dear NEA Scratch Pad:

I understand that petroleum is used for eczema-prone skin. However, I don't like to use petroleum. I've tried different balms from spas, and found that I could make my own, using beeswax and oil (olive or almond oil). My latest balm is what I call a Bumble Bee Balm. I've only used it on my own skin, and it works for me. I hope you find it useful, too. I realize this will not be an option for people with certain allergies. I purchased the bee products from Rainbow Groceries in San Francisco.

1/4 ounce beeswax
1 cup oil (olive or almond)
manuka honey
royal jelly
propolis
bee

New Research Fuels Greater Understanding of Atopic Dermatitis and Psoriasis in Children and Adolescents

BOSTON (Aug. 16, 2012)  Information presented at American Academy of Dermatology’s Summer Academy Meeting by Lawrence F. Eichenfield, MD, FAAD, a board-certified pediatric dermatologist, chief, division of pediatric and adolescent dermatology and professor of pediatrics and medicine (dermatology), Rady Children’s Hospital and University of California, San Diego School of Medicine.  Dr. Eichenfield is also a member of the National Eczema Association Scientific Advisory Committee.

OVERVIEW
For the millions of children and adolescents affected by chronic skin conditions such as atopic

Dermatology Physicians Residents - Perspectives on Eczema

Submitted by Garibyan_Huang
on Thu, 08/09/2012 - 5:08pm

We first learned about atopic dermatitis while studying medicine at Harvard Medical School.  It was introduced to us during dermatology lectures where photos of mostly young children where shown with uncomfortable and itchy appearing rashes.  At that time, this was another disease that we had to learn and memorize the symptoms and the diagnostic criteria for our exams.  

This all changed a few years ago after we started residency and rotated through pediatric dermatology at Children’s Hospital Boston when we actually got to see and interact with the patients and family members of those

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Children
Flare-ups
Atopic Dermatitis
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Good Results with Multivitamins

Then my aunt suggested I take a multivitamin. I went the grocery store and found Women’s One a Day Plus Healthy Skin Support with FloraGlo Lutein in it. Since starting the vitamin three weeks ago my eczema is almost completely gone.

Video: E.T. - Eczema as a Teen

It can be lonely growing up with eczema because it is so hard to talk about, especially when you're a self-conscious teenager. Here's a message to everyone with eczema and those who care about them: you are not alone!

Infant and Toddler Eczema

Eczema is a chronic itchy skin condition. Eczema usually starts within the first five years of life, most often in the first six months. It typically lasts into childhood and adolescence. In some cases it may last into adulthood.

Education Resource Center: What Causes Eczema

The exact cause of eczema is unknown. You might have inherited a tendency for eczema. You may have a family member who has eczema or who has hay fever (allergic rhinitis) or asthma. Many doctors think eczema is linked to allergic disease, such as hay fever or asthma. Doctors call this the atopic triad.

Clinical Aspects of Eczema

I hope to shed some light on the clinical aspects of atopic dermatitis, or eczema. I’m going to talk about the treatment of inflammation including the use of topical steroids and the calcineurin inhibitors Elidel and Protopic. I’ll also talk about treating itch and sleep disruption and infection. I hope to help you make sense of all the medicines used to treat this disease.

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