The atopic dermatitis is a chronic inflammatory disease that causes skin rashes that pican and they flakeeczema). Although it most often affects childhood (20% of children), it can persist and / or appear for the first time in adolescence or adulthood (3-10% of adults). “The debut was more frequent in children, but in recent years they make their debut in adulthood and why is the million dollar question”, points out Dr. Esther Serra, a dermatologist member of the Spanish Association of Dermatology (AEDV) and an expert in this pathology.
One of the hypotheses that could explain the appearance of this disease in adults who did not have clinical manifestations in childhood is that they already have a genetic component and it is the environmental exposome (the set of exposure factors to which a person is subjected from the moment of conception until death) which triggers the first outbreak.
“Atopic patients frequently report a personal or family history of asthma or allergic rhinitis or atopic dermatitis,” Dr. Serra explains to ABC Salud. There are four factors involved in its appearance, explains the expert: “genetic predisposition, impaired immunity, dysfunction of the epidermal barrier and environmental factors.”
The general perception is that more and more people are living with this pathology. «It is not well known what is the cause of this increase because this is a multifactorial disease (involving genetics, immunity, the environment and the skin barrier factor), but existing changes in lifestyle could be responsible for this increase. The more developed the countries are, the more atopia, ”says the AEDV expert.
The intense itching generated by atopic dermatitis greatly affects the quality of life of patients. Therefore, it is important that the appropriate treatment is followed in each case. Currently there is a therapeutic arsenal that allows to control outbreaks. In addition, although it is a chronic disease, in almost 70% of cases the cutaneous clinical manifestations disappear in adulthood.
Daily skin care is essential in a patient with atopic dermatitis. The first is a good maintenance of the skin barrier with the specific hygiene products and emollients for this type of skin (consult the dermatologist and the pharmacist). «Only when there is eczema, will corticosteroids topicals and / or calcineurin inhibitors ”, explains Dr. Serra. Oral corticosteroids may also be necessary only in very specific cases for a short time.
But if this approach fails to control outbreaks, it will be necessary to move on to systemic treatment. “There is the possibility of using UVB phototherapy or immunosuppressive drugs and, if it is not enough, we currently have a biological drug that has changed the lives of patients, “says Dr. Serra. The expert points out that, in the near future, there will be more drugs of this type that will allow a more personalized treatment in moderate-severe cases.
In the treatment of dermatitis, the dermatologist also considers essential the psychological advice. «This disease greatly affects the quality of life of the patient because the itching that it produces affects rest, can cause anxiety, etc. The psychologist follows them up and teaches them relaxation techniques. It is a very important part ”, he assures.
Although we live in the era of “Dr. Google”, Dr. Serra discourages patients from searching for information online. Better go directly to the specialist. “The longer it takes to go to the doctor, the worse it gets,” he warns.