Neurodermatitis also called atopic dermatitis or atopic eczema is a skin disease that starts with itching and at an early age, usually in childhood, although a form of onset in adulthood is known. Pruritus, eczema, xerosis (dryness of the skin), and lichenification (thickening) are characteristic symptoms.
Neurodermatitis can occur in association with other atopic diseases (which increases the secretion of immunoglobulin E), as well as acute food allergies, asthma, urticaria and allergic rhinitis. Neurodermatitis is an increasingly common disease, especially in developed countries.
Can Neurodermatitis Go Away?
In 85% of the cases, the neurodermatitis begins in the first year of life, 95% of all cases occur before the age of five. Incidence is very high in childhood. The neurodermatitis disease can present during long periods of complete remission, especially in adolescence, but it can reappear in adulthood.
Neurodermatitis is just one symptom: persistent pruritus, in addition to clinical signs such as excessive dry skin, irritation, redness, lichenification, and eczema. Frequently, parents do not take into account the disease until their children scratch the lesions (these appear after persistent scratching in a specific area of the body). The skin is red due to scratching but the disease has numerous periods of remission and relapse. In most patients, there are very obvious signs of the disease in childhood, adolescence, and relapse resolution in adulthood. However, there is neurodermatitis that starts late, after the 20’s.
The main signs of neurodermatitis are skin lesions, skin lichenification, and dry eczema. Superficial scoriation of the scaly skin and the development of the signs appear very frequently. The location of eczematous lesions varies according to the age of the patient. The most common occurrence occurs around the age of 2-3 months.
In babies, the first signs of neurodermatitis are observed immediately after birth. Dry skin occurs very early and usually covers the entire skin of the body. Generally, the diaper area is not affected because the humidity there is higher.
The lesions appear for the first time in the antecubital and popliteal fossa showing erythema and serous exudates. In the next few weeks, the lesions will spread to the cheeks, forehead, and scalp and to the extension of the legs. They generally appear throughout the body, except the nose and the area covered by the diaper. The lesions are well-defined crusts and plaques covered by the erythematous and eczematous epidermis. Lichenification rarely occurs in babies, but bullous lesions filled with fluid on the surface of the eczema erythematous eruption can appear. These lesions must be supervised because they can easily get infected.
For children over 2 years old, they present dry, sagging skin and are hard to the touch.
Adult lesions are more diffuse and less pronounced they are usually erythematous. The face is the most commonly involved and it is particularly very dry, mostly in winter, when the temperatures are very low and extremely dry. The body is affected by xerosis, lichenification may be present or absent, and scratching is rare. In some patients, there is a brown ring around the neck, which is a deposit of localized amyloid. Patients with neurodermatitis skin may have a darker pigmentation in certain parts of the body and healing in areas that scratching was intense.
The treatment of atopic dermatitis consists of two parts: a basic treatment for the care of the skin and the treatment of inflammation of the skin.
The basic treatment is the careful care of the skin. Apply generously skin care products that help keep it well hydrated and with grease.
Medicines against inflammation of the skin are prescribed according to the severity, the affected places and the evolution of the disease. The goal is to treat acute skin disorders. In addition, they must avoid the appearance of new symptoms in the asymptomatic phases. This treatment includes the following points:
-Topical treatment with creams, ointments or emulsions.
-Systemic treatment in the form of tablets or infusions.
In most mild to moderate neurodermatitis cases, topical therapy is sufficient, since it improves the symptoms considerably. In addition, medications that are well tolerated such as antihistamines can be added. Only in very severe cases are systemic treatment with inhibitors of inflammation is necessary.
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