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Dermatology

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Atopic dermatitis or eczema

Atopic dermatitis, or atopic eczema, is a common and recurrent skin disease that occurs all over the world and can appear at any age. However, 70-95% of cases appear before the age of five. It is characterised by redness and inflammation of the skin (eczema) and prolonged, severe itching. It is a disease in which there is a genetic basis with a variable expression influenced by environmental factors. Patients with atopic dermatitis have an altered skin barrier function; the skin shows increased transepidermal water loss and lower skin surface hydration levels. The alteration of the skin barrier makes the skin more susceptible to environmental factors such as irritants, allergens and microbes. The main symptom is severe itchiness (pruritus). It is often worse at night, or when sweating or wearing woollen clothes. The scratching that occurs as a result of the itching can make the lesions worse and cause infection. Patients with atopic dermatitis may have several symptoms and clinical features. Here are the most common: to treat atopic dermatitis or atopic eczema a thorough medical history must be conducted and various factors taken into account, including: the age of the patient, previous treatment undertaken, the severity of the lesions, the number of annual outbreaks and the preferences and expectations of the patient. The most commonly-used pharmacological agents include topical corticosteroids, topical immunomodulators, oral and topical antibiotics and oral antihistamines. For patients with severe forms of atopic dermatitis, and who are refractory to these treatments, other options exist such as systemic immunosuppressive drugs for the skin (eczema) and for prolonged, severe itching.