$Unique_ID{BRK01129} $Pretitle{} $Title{Treatments for Chronic Atopic Dermatitis} $Subject{dermatitis rash atopic Skin reddened inflamed inflammation scales crusts intense itching pustules pustule blister blisters allergic allergies allergy topical corticosteroids ultraviolet light Antihistamines} $Volume{L-20,U-20} $Log{ Skin Testing for Allergens*0001301.scf Reactions From an Allergy Scratch Test*0001302.scf} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Treatments for Chronic Atopic Dermatitis ------------------------------------------------------------------------------ QUESTION: My question may be more than you care to take on, but I am always on the lookout for something new. My five year old son has a bad case of chronic atopic dermatitis, and we have made the rounds of almost all the doctors in town. All the treatments are somewhat effective for short periods of time, but the itching is enough to drive him crazy. Can you offer any suggestions that might help? ------------------------------------------------------------------------------ ANSWER: There are a few new ideas to report that may be helpful and I am happy to share them with you. About 0.5 to 1 percent of the general population suffer with this annoying skin disease that is characterized by reddened inflamed skin, scales and crusts, and intense itching. When in the acute stage, the affected areas may be covered by pustules and blisters, as well as a serous liquid. It is easy to see how scratching may bring about additional infections, which further complicate the symptoms and the treatments. But it is the persistent and intense itching that makes this rash so hard to put up with, and for which all patients request some type of help. It now seems clear that in the majority of cases there is an additional history of allergic disease. Discovering the allergic substance through skin testing and eliminating it from the environment may lead to a lessening of itching and a reduction in the severity of the rash. Treatments that may help include techniques to keep the skin well hydrated, tepid water soaks or baths, followed by medications and dressings that prevent evaporation of the moisture. A wet garment such as a sock, covered by a dry one, may serve for feet, ankles and legs, while wet gauze dressings covered by Ace bandages may serve well in other areas. When at its acute stage, topical corticosteroids may be prescribed by your physician, but oral medications are not generally used. Though there is a dramatic improvement with these oral medications, the rash and discomfort return just as rapidly when the medication is discontinued. In chronic cases that do not respond well, ultraviolet light my be a useful addition to the treatment, and can be helpful when administered three or four times a week. Antihistamines may also be quite effective in reducing the intensity of itching and may reduce the irresistible urge to scratch. The good news is that for most, atopic dermatitis tends to improve as the child grows older, and may disappear completely. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.