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$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.