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Irritated, Itchy, Atopic Skin

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A more severe form of very dry skin, irritated skin with itching is considered atopic skin. This skin disease starts at a very young age and has all the characteristics of a genuine epidemic. It is even one of the main causes of visits to the dermatologist! In the past 30 years, the number of cases of atopic dermatitis has doubled or even tripled in western countries*. Atopic skin is not well known or understood, yet it disrupts the lives of children and their parents. However, recent scientific discoveries have improved understanding of the illness and changed the way it is treated starting at birth.


*Dermatite atopique: épidémiologie en France, définitions, histoire naturelle, association aux autres manifestations atopiques, scores de gravité, qualité de vie (Atopic dermatitis: Epidemiology in France, Natural History, Association with Other Atopic Manifestations, Severity Scores, Quality of Life). E. Mahé. Ann. Dermatol. Venereol. 2005 ; 132

Summary
  1. What are the signs of atopic skin?
  2. What causes atopy?
  3. Atopic Dermatitis Progression
  4. Who is affected?

What are the signs of atopic skin?

Atopic dermatitis is an inflammatory skin disease that is characterised by extreme dryness and red patches often covered with small vesicles (small “blisters”) that cause intense itching. Atopic dermatitis is a benign and non-contagious chronic disease with flare-ups of eczema. These acute break-outs have a significant impact on quality of life and often cause insomnia. Over time, an atopic profile can manifest in other allergies such as asthma, allergic rhinitis or allergic conjunctivitis. The complications are bacterial or viral (herpes) secondary infections. Molluscum contagiosum, a viral condition, also appears more often on atopic profiles.

What causes atopy?

The skin is extremely dry and becomes more permeable, no longer playing its barrier role against external stresses and allergens. But not all dry skin becomes atopic. Atopy develops on profiles with a genetic predisposition. Studies have shown that if one parent has atopic skin, the probability of the child having the same skin condition is 30%**. If both parents are affected, the probability is 70%**. In addition to the genetic factor, atopic skin is also related to an abnormal immune system, which over-reacts, creating inflammation. The epidermis becomes permeable to allergens (mites, animal hair, pollen) and certain bacteria (Staphylococcus aureus), which trigger inflammatory reactions. Food allergies (cow’s milk, eggs, etc.) are also involved digestively in triggering certain eczema flare-ups. Other factors such as chemical products applied to the skin, heat or perspiration are irritants that cause these flare-ups. However, in the vast majority of cases, atopic children do not have food allergies. Food allergies manifest themselves as digestive signs and a “break” in height and weight curves.


**Dermatite atopique. SA Büchner. Swiss Medical Forum No. 19, May 2001

Atopic Dermatitis Progression

  • Stage 1

Atopic dermatitis generally starts between the second and third months of life when highly-localised red patches appear on the cheeks, and hands, then spread to flexion creases on the knees and elbows. The illness evolves through flare-ups over one to two years. The skin is permanently dry, which leads to itching, causing insomnia and a decrease in quality of life.

  • Stage 2

After several years, some children may develop other atopy signs, such as allergic rhinitis and/or allergic asthma. This is the last stage of the “atopic march”. It often involves scratching and high rates of staphylococcus aureus colonisation on the skin.

Therefore, in order to prevent it from appearing and worsening, the scientific community currently recommends early management from birth to treat atopic skin in newborns who do not yet show signs of the condition but who have a favourable genetic predisposition.

Who is affected?

People affected are genetically prone to allergies (atopy-prone). They may also have respiratory problems (asthma), problems in the ears, nose and throat (allergic rhinitis), eye problems (allergic conjunctivitis) or digestive problems (food allergy). Babies and infants are the most likely to be affected, usually between three months and five years, with a peak of 80% of cases appearing before the age of one. But atopic skin can persist longer, up to adulthood.

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