Pediatric atopic dermatitis

What is pediatric atopic dermatitis?

Atopic dermatitis (at·​o·​pic - der·​ma·​ti·​tis) is a severe form of eczema that causes scaly and itchy rashes. In most cases, it first appears in infants between the ages of 6 and 12 weeks. As many as 15 to 20 percent of children have atopic dermatitis but for some of them, symptoms will disappear by the time they reach early adulthood.

Atopic dermatitis typically involves skin folds but may also include the cheeks, trunk, arms and legs. Many children with this condition have a personal or family history of seasonal allergies or asthma.

Your child may complain of itching, which is followed by a red rash. Your child's symptoms may be continuous or they may come and go. If your child scratches these patches, it can promote infection. Many children outgrow the condition or have milder cases as adults. For others, it is a chronic condition that requires more than one treatment.

What are the signs and symptoms of pediatric atopic dermatitis?

• Bumpy skin (especially on the thighs or on the back of the arms)

• Discharge or bleeding from the ears

• Dry skin over large areas of the body

• Excessive itching (which may begin before a rash appears)

• Leathery or thick skin (from long-term scratching)

• Oozing, crusting blisters surrounded by redness or inflammation

• Rashes

• Raw patches of skin (from scratching)

• Skin discoloration (mottled)

How is pediatric atopic dermatitis diagnosed?

To diagnose atopic dermatitis, your child’s doctor will conduct a physical examination and ask some general health questions.

What are the causes of pediatric atopic dermatitis?

The exact causes of atopic dermatitis aren't known, but it may be an autoimmune disorder triggered by a combination of environmental and genetic factors. Children with a parent who has atopic dermatitis are more likely to develop it, as are those with a parent who has hay fever or asthma.

Seasonal allergens, certain soaps and detergents, weather changes, stress and even food allergies can trigger or worsen an atopic dermatitis flare-up.

How is pediatric atopic dermatitis treated?

Because atopic dermatitis is a chronic condition, it is important that your child stays away from triggers and avoids scratching affected areas of the skin.

Treatments may include:

• Antihistamines to reduce itching

• Antibiotic creams (for skin infections)

• Immune-suppressing drugs including cyclosporine, methotrexate and mycophenolate mofetil

• Keeping your child's fingernails cut short to prevent intense scratching

• Limited use of systemic steroids

• Lubricating your child's skin with ointments (petroleum jelly) or creams and lotions

• Topical corticosteroid creams or moisturizers (prescribed by your child's doctor)

• Phototherapy (a type of UV light therapy)

• Using a humidifier to keep the air moist

Things to avoid include:

• Chemicals and solvents

• Exposure to water for long periods of time (give your child shorter, cooler baths)

• Foods that may cause allergic reactions

• Irritants such as cigarette smoke or pollution

• Sudden changes in temperature

• Stress

• Scrubbing or drying the skin

• Soaps or detergents that include alcohol, scents or dyes

• Wool or synthetic clothing