Atopic dermatitis: A skin disorder that can affect children’s quality of life

Atopic dermatitis, sometimes called as “asthma of the skin,” may not clinch prime-time news coverage the way major diseases or epidemics do.

But its silent and lingering impact on the lives and daily activities of sufferers must not be taken for granted, doctors cautioned.

Atopic dermatitis is a chronic, relapsing, and inherited inflammatory condition of the skin more commonly diagnosed among infants and children.

It usually begins during infancy, and is more significantly prevalent among children aged below five years old. However, adults and the elderly are not immune to atopic dermatitis, which is sometimes referred to as atopic eczema.

'Thousands of polka dots'

Atopic dermatitis is a "stubborn" skin disorder characterized by itching, which may turn severe during night time. It can be seen as reddish to brownish colored patches on the skin, with small and raised bumps. These bumps over scaly, cracked, and thickened skin may leak fluid and crust over when scratched.

“If atopic dermatitis is not controlled, sufferers scratch more often their skin, thus causing more damage to skin,” said Dr. Adelaide Ann Hebert, professor at the Department of Dermatology and Department of Pediatrics at the University of Texas Health Science Center in Houston.

Hebert likened the skin of a child covered with atopic dermatitis to “skin covered with thousands of polka dots.”

“When water comes out from these polka dots, the trigger factors come in. The role of care-givers or parents is to control those polka dots, fill those polka dots, and make the skin normal again,” Hebert said in an interview during the recent launch of “Guide to Understanding Moisturizers in Atopic Dermatitis.”

The book, a handy reference for medical doctors dealing with atopic dermatitis, is a project of the Pediatric Dermatology Subspecialty Core Group of the Philippine Dermatological Society.

“Caregivers and parents must realize those polka dots are an ongoing phenomenon. It is not as if they can seal them one time, and it is done. They have to seal the skin and fill those holes daily and let the skin heal,” Hebert said.

Soothe the skin

Itchiness caused by atopic dermatitis causes severe discomfort among sufferers, especially children, that they do not sleep well, Hebert said.

“When children do not sleep well, the caregivers or parents are affected too. We know from studies that parents or caregivers can lose from one hour to one hour and 30 minutes of sleep if their children suffer from atopic dermatitis,” Hebert said.

Hebert advised caregivers and parents of atopic dermatitis sufferers to use appropriate moisturizer at least twice a day to soothe the affected skin parts and relieve discomforts to enable them to sleep well. “Good moisturizer is essential to health care. We want children to lead full normal lives.”

‘If their children sleep well, parents and caregivers can sleep well too. Sleep helps children focus on their daily activities. We want them to participate fully in school. If children do not sleep well, they cannot cope with their activities the next day,” Hebert said.

A common problem

Dr. Melinda Atienza, president of the Philippine Pediatric Society, said in a separate interview that atopic dermatitis is “quite common” in the Philippines, affecting two to three children out of 10 across socio-economic groups and in both genders.

It should be a cause for concern for parents and caregivers, she said. Atopic dermatitis, if not treated properly, can worsen. Scratching the skin rashes can make them even itchier and lead to more inflammation and more frequent scratching.

“Persistent atopic dermatitis will lead to scratching. Babies and young children become irritable and thus affecting their daily lives,” Atienza said.

“Repeated scratching may break the skin and lead to secondary bacterial infections. The infection may progress into to severe Staphylococcus aureus infection. Infections can harm kidneys,” Atienza said.

She said the “allergic march” has three “presentations or sequences”: first, atopic dermatitis or asthma of the skin; second, allergic rhinitis due to exposure to allergens such as smoke, pets, dust, fragrant powders and soaps; and third, bronchial asthma.

Moisturizing is important

Hebert advised applying regular moisturizers to dry skin areas and Atopiclair on the affected part. “This will save money,” she said.

“One advantage of Atopiclair compared with regular moisturizers is that it contains ingredients that reduce inflammation, help control itchiness, soothe the skin, and promote healing,” Hebert added.

“We have to minimize exposure to what causes atopic dermatitis and must protect the skin by using appropriate moisturizers and emollients,” Atienza said.

Meanwhile, Maria Victoria Dizon, chair of the Pediatric Dermatology Subspecialty Core Group of the Philippine Dermatological Society and associate professor at the UST Faculty of Medicine and Surgery, said the guidebook on moisturizers and atopic dermatitis “serves to provide Filipino physicians with a complete and concise source of information about moisturizers, giving clinicians a deeper understanding of what moisturizers are and what makes them different from one another.”  — BM, GMA News