What is Eczema?
- Atopic eczema is also well know as atopic dermatitis.
- Atopic dermatitis usually develops in early childhood, with approximately 70% of patients developing disease in the first 5 years of life.
- The disease affect less than 2% of adults.
- Asthma and Hay fever are also regarded as Atopic Diseases and are frequently associated with atopic eczema.
- Asthma develops in approximately 30% of children with atopic dermatitis.
- Allergic rhinitis develops in approximately 35% of children with atopic dermatitis.
- Atopic dermatitis can present as several stages such as erythema, edema, oozing, crusting, vesiculation, excoriations, lichenification, dryness, scaling, cracking, post inflammatory hyper/hypo-pigmentation.
- In adults, the disease can impact on career choices and lead to time off work or even loss of employment
- Out-of-pocket expenses for patients and their family are also high, with the added financial burden contributing further to the social and psychological impact of the disease.
Treatment of Atopy Dermatitis
- Treatment should be geared to the level of impairment of quality of life in each individual case and not exclusively to visible severity.
- Although emollients and topical corticosteroids remain standard first-line therapy, the topical calcineurin inhibitors such as protopic represent a useful second-line treatment option, particularly eczema on the face and flexures.
- Patients with regular flare-ups (more than 2-3 a month) may benefit from proactive treatment to problem areas with twice weekly application of topical corticosteroid or topical calcineurin inhibitor, to treat sub-clinical inflammation in between flare-ups, even the skin visibly clear.
Reasons for Poor Response to Therapy
- Poor compliance.
- Inadequate Strength of medications.
- Secondary bacterial or herpetic infection.
- Superimposed contact allergy.