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Atopic dermatitis / Eczema
Atopic dermatitis (also referred to as atopic eczema) is an itchy, chronic inflammation of the skin. Diagnosis is primarily based on appearance of skin and on personal and family history. The prevalence of atopic eczema is about 20 percent in Malaysia and Singapore with 90 percent of suffers developing the condition before age of 5 years. Classic signs of atopic dermatitis include itchy reddish skin and in severe cases the skin lesions may be infected. In the young, the rashes typically appear on the cheeks, forehead or scalp, on arms and trunk. Scratching causes the rash to spread. Atopic dermatitis is a relapsing-remitting condition which flares-up periodically often triggered by allergens, irritant chemicals and stress. Atopic dermatitis and asthma are characterized by elevated levels of serum IgE antibodies directed to aeroallergens and common foods. These antibodies can be detected by CAP RAST blood tests. Atopic dermatitis in the young children is risk factor for the development of airways disease including asthma later in life. Thus, children 5 to 7 years old may develop allergic rhinitis and asthma if they had food-triggered allergic dermatitis during infancy.
Treatment of the disease should include (1) Educating the suffer of the disorder, (2) Identifying the trigger factors through CAP RAST blood tests and avoiding the offending allergens, (3) Moisturing the skin immediately after bath to prevent dryness, and (4) Application of anti-inflammation medication, such as steroids for short periods but not more than 3 weeks and immunomodulating agents such as tacrolimus or pimecrolimus which are also suitable in small children.