Atopic dermatitis, or eczema, is a chronic skin disease estimated to occur in 10% of children. Those affected have dry skin with an itchy, red rash. The rash typically affects the insides of the elbows, back of the knees, and the face; however, it can also cover the entire body.
Weeping sores may develop due to vigorous scratching or infection. The scratching is felt to play a major role in the development of the eczematous rash. Bacterial skin infection is common and causes more itching and redness. While the exact cause is not known, eczema is frequently associated with allergies (e.g. foods, dust, pollens, animals) and irritating substance (e.g. soaps, chemicals). Other common triggers include skin infections, heat, sweating, and emotional stress. Eczema is not contagious; it is inherited from one’s parents.
At present, eczema cannot be cured, but it can usually be managed so that the child can play and live comfortably. For most individuals, eczema improves significantly by age 3. Statistics suggest that approximately 50% will completely lose their rash, and 40% will have only mild skin lesions. However, the remaining 10% continue to have problems with eczema into adulthood (although perhaps less severe). Approximately 75% of children with eczema will develop allergic rhinitis (hay fever) and/or asthma.
About 1/3 of infants and young children with eczema have food allergy. Appropriate diagnosis of food allergy (accomplished with skin tests and blood tests) and elimination of the offending allergen leads to significant clearing or improvement of the skin rash in many young children with both eczema and food allergy. The allergist will also discuss ways to manage eczema through proper skin care and prescribe medications (antihistamine, antibiotics, topical steroidal and non-steroidal creams) to treat the red rash or flared areas. Studies have shown that inhalant and environmental allergy immunotherapy has been shown to be efficacious in allergic patients with eczema.