What to do if there is a skin disease?

ATOPIC DERMATITIS - GENERAL INFORMATION

Atopic dermatitis (AD), also called atopic eczema, is a common skin allergy that usually begins in early childhood. It can be associated with skin infection (bacteria, fungi, candida and viruses). Half of patients with moderate to severe AD also suffer from asthma, allergic rhinitis (hay fever) and food allergies. The main symptom is itchy skin. Usually the skin is also dry. When scratching, the skin becomes red, irritated and thickened.

It is now believed that AD is due to a "porous" skin barrier. This allows the water to come out, and thus the skin dries. Porous skin may be due to genes inherited from parents or environmental factors:
• Defects in the phylagrin gene can cause moderate to severe AD in up to one third of people with ancestors from Northern Europe and East Asia.
• Exposure to soaps, detergents, house dust mites, pollen, animal dander and some bacteria, which contain proteins called "proteases," can exacerbate AD. Proteases break the bonds that bind the cells of the epidermis and generate a porous skin barrier.
 To improve the skin barrier, moisturizers are used. To help the skin does not get irritated, you can also wear clothes that cover arms and legs. When there is a lot of redness, the application of creams and ointments that decrease inflammation is often indicated.

ATOPIC DERMATITIS - SYMPTOMS AND DIAGNOSIS

In infants and children, the rash is usually seen on the scalp, knees, elbows and cheeks.
 In adults, rash can occur in folds of wrists, elbows, knees, ankles, face and neck.
 The rash is usually scaly, itchy and red. Because the rash causes itching, scratch marks often appear. If you have this itching for a long period of time, the affected skin may thicken.
 Dry skin can make itching and rash worse. An "itch-scratch cycle" can occur because rubbing or scratching the skin can cause more irritation and thus more itching.
 The rash usually gets worse if certain foods are eaten. In the case of eczema, it is usually a delayed reaction. However, other reactions to food can occur more immediately, including hives (welts that itch) and inflammation. Allergy tests, either by blood (blood collection) or allergy skin tests (minimum amounts of food are applied in liquid form on arms or back and 10-15 minutes are expected for a "pruritic lump" to indicate an allergy) can be performed by an allergist / immunologist to determine the possible presence of an immediate food allergen. Allergy tests are generally positive in patients who tolerate food in their diet and, in this way, food should not be removed from their diet solely on the basis of the results of these tests.
 It is important that you inform the allergist / immunologist about your rash. Other types of rashes, such as psoriasis and contact dermatitis (poison ivy) can occur as the eruption of atopic dermatitis. In addition, people who have several other immune problems, such as immune deficiencies (weak immune system) and vitamin deficiencies (low vitamin levels) may have a similar rash. The final diagnosis of atopic dermatitis should be made by your allergist / immunologist.

ATOPIC DERMATITIS - TREATMENT AND CONTROL

The main goal of treatment is to improve your quality of life. You must be able to participate in your school, work, social and family activities. You should feel healthy and satisfied with the appearance of your skin. There should not be a social stigma associated with this disease. You should have few or no side effects caused by the treatment for a topic dermatitis. In addition, sleep should be restful and uninterrupted by the need to scratch the skin.
 Need to avoid possible triggers
Irritants: Irritating agents such as chemicals, soaps, detergents, fragrances, certain fabrics and smoke can further irritate the skin of patients with a topic dermatitis.
These are the steps that must be followed to reduce exposure to irritants:
• Wear comfortable clothes.
• Wash all new clothes before using them.
• Keep nails short and smooth to avoid further damage to the skin from scratching.
• Use protective sunscreen for broad-spectrum UV rays (UV-A and UV-B with an SPF of 15 or higher).
• Bathe immediately after swimming to reduce and remove exposure to various chemicals found in swimming pools and beaches.
 Biological medications are the newest anti-inflammatory medications that have been approved for other allergic diseases, such as asthma, and for other skin conditions, such as psoriasis.
 They have been studied in patients with difficult to treat atopic dermatitis, and a biological agent has recently been approved for the treatment of very severe atopic dermatitis. You should discuss biological medications with your allergist / immunologist. 

Probiotics

Despite the enormous attention that the media pay to probiotics, there is currently no definitive evidence to show that the use of probiotics improves or prevents atopic dermatitis, and is currently not recommended in the routine treatment of atopic dermatitis.
 Allergy shots (allergy shots)
Allergy vaccines (administration under the skin of the arm of small doses of what you are allergic to, such as dust mites) are currently approved for the treatment of asthma and allergic rhinitis (hay fever). Allergy shots can help some patients with allergic dermatitis. Allergy shots are not the same as injectable steroid or steroid shots. Your allergist / immunologist will indicate if allergy shots are appropriate for your atopic dermatitis.
 In summary, atopic dermatitis is generally manageable, regardless of the patient's age. Currently, there are many treatments available and future therapies on the way. With careful evaluation and follow-up of the allergist / immunologist, you can have a very good quality of life and enjoy all your activities.