$Unique_ID{BRK03657} $Pretitle{} $Title{Dermatitis, Atopic} $Subject{Dermatitis Atopic Atopic Eczema Besnier Prurigo Constitutional Eczema Dermatitis Disseminated Neurodermatitis Eczema Contact Dermatitis Dyshidrosis Psoriasis} $Volume{} $Log{} Copyright (C) 1990, 1991, 1992 National Organization for Rare Disorders, Inc. 801: Dermatitis, Atopic ** IMPORTANT ** It is possible that the main title of the article (Dermatitis, Atopic) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Atopic Eczema Besnier Prurigo Constitutional Eczema Dermatitis Disseminated Neurodermatitis Eczema Information on the following disorders can be found in the Related Disorders section of this report: Contact Dermatitis Dyshidrosis Psoriasis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Atopic Dermatitis is a common chronic inherited form of eczema. Eczema is a skin condition characterized by redness, swelling (edema), oozing, crusting, scaling, burning pain, and itching (pruritus). Scratching or rubbing eczema may lead to thickening and marking of the skin (lichenification). The causes of eczema fall into two classifications: 1) constitutional eczema (Atopic Dermatitis), and 2) external eczema which is caused by allergies, irritations, or chemical reactions such as in Contact Dermatitis (see Related Disorders section for more information). Symptoms Atopic Dermatitis is a chronic inherited form of eczema characterized by red, oozing and weeping skin inflammation with itching. There are three forms: infantile, childhood, and adult eczema. Usually, the first two forms clear up during childhood. The adult form may become either widespread over the entire body surface or may be limited to a small area such as on the hands or scalp only. Patients with this form of eczema usually have highly sensitive skin, decreased skin-oil production, a low itch tolerance, and abnormal sweating activity. Clothing (especially wool or silk), emotional stress, harsh soap, grease, oils, some detergents, extreme heat or cold, sweating, or irritating medications may trigger Atopic Dermatitis. Itching may lead to excessive scratching which worsens the condition and is referred to as the "itch- scratch-itch syndrome." In many patients, other allergies such as asthma, hay fever or hives often accompany Atopic Dermatitis. Food hypersensitivity in children may also be associated with Atopic Dermatitis. However, the eczema is not caused by pollen or other airborne irritants. Causes The exact cause of Atopic Dermatitis is not known, although the susceptibility to eczema is believed to be an inherited trait. In children with food allergies or hypersensitivity, an immune response may trigger reactions within the skin. Human traits, including the classic genetic diseases, are the product of the interaction of two genes, one received from the father and one from the mother. It has not been clearly established yet whether Atopic Dermatitis is inherited as an autosomal dominant or recessive trait. In dominant disorders a single copy of the disease gene (received from either the mother or father) will be expressed "dominating" the other normal gene and resulting in appearance of the disease. The risk of transmitting the disorder from affected parent to offspring is fifty percent for each pregnancy regardless of the sex of the resulting child. In recessive disorders, the condition does not appear unless a person inherits the same defective gene for the same trait from each parent. If one receives one normal gene and one gene for the disease, the person will be a carrier for the disease, but usually will show no symptoms. The risk of transmitting the disease to the children of a couple, both of whom are carriers for a recessive disorder, is twenty-five percent. Fifty percent of their children will be carriers, but healthy as described above. Twenty-five percent of their children will receive both normal genes, one from each parent, and will be genetically normal. Affected Population Atopic Dermatitis primarily affects infants and children, although there is an adult form as well. It affects males and females in equal numbers. Related Disorders Symptoms of the following disorders can be similar to those of Atopic Dermatitis. Comparisons may be useful for a differential diagnosis: Contact Dermatitis is a common disorder characterized an acute or chronic skin inflammation triggered by substances that come in contact with the skin. Allergic Contact Dermatitis may be due to delayed hypersensitivity. (For more information on this disorder, choose "Contact Dermatitis" as your search term in the Rare Disease Database). Dyshidrosis (Difficult Sweating; Hand Eczema; Cheiropompholyx; Pompholyx) is a disorder of unknown cause, characterized initially by deep-seated itchy blisters or elevated spots usually on the sides of the fingers. Later, the skin of the hands may become dry, scaly, hardened, and fissured. The feet may also be affected. Psoriasis is a common chronic and recurrent skin disorder characterized by dry, well-circumscribed silvery gray scaling spots or plaques which usually appear on the scalp, elbows, knees, back, or buttocks. In a few cases, the entire body may be affected. (For more information on this disorder, choose "Psoriasis" as your search term in the Rare Disease Database). Therapies: Standard Treatment of Atopic Dermatitis usually involves a combination of environmental, personal, and medical measures. Diagnosis of the disorder can be made by blood tests for the immunoglobulin levels in the blood. Treatment of Atopic Dermatitis includes emollient creams to keep the skin lubricated, corticosteroid creams and antihistamines to decrease itching, and antibiotics such as hydroxizine (Atarax) and diphenhydramine (Benadryl) for secondary bacterial infections. Tar preparations or ultraviolet light therapy may also benefit the patient. Wet compresses or dressings may help when the skin is oozing or weeping. Mild lanolin-based soaps and bath oil are generally recommended for bathing. Mild laundry detergents can be used to prevent clothing from irritating the skin. Therapies: Investigational Research on diseases of the skin is ongoing at the National Institute of Arthritis, Musculoskeletal and Skin Diseases which is listed in the Resources section of this report. Clinical trials are underway to study patients with Hyper-IgE Syndrome and high serum IgE levels. Interested persons may wish to contact: Rebecca H. Buckley, M.D. Box 2898 Duke University Medical Center Durham, NC 27710 (919) 684-2922 to see if further patients are needed for this research. This disease entry is based upon medical information available through January 1992. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Atopic Dermatitis, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 References THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS COMPLETE HOME MEDICAL GUIDE: Donald F. Tapley, M.D., et al., eds; Crown Publishers, Inc., 1985. Pp. 624, 641. INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1377-1378. MENDELIAN INHERITANCE IN MAN, 8th Ed.: Victor A. McKusick; Johns Hopkins University Press, 1986. Pp. 832. WORLD BOOK MEDICAL ENCYCLOPEDIA: Erich E. Brueschke, M.D., et al., eds; World Book, Inc., 1988. Pp. 295-296.