Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Understanding and Controlling Atopic Dematitis in Children



Atopic dermatitis (eczema) is a skin disease characterized by thickened rough skin eruptions. The hallmark of the disease is itching. Typically the disease is inherited in a family which has allergies.

Characteristic areas of the body are typically involved with eczema in different age groups. In infants, it is usually found on the face with red, rough cheeks. This later spreads to the outer extremities. As the children become older, it progresses to the inner surfaces or flexor surface of the extremities.

Eczema is frequently associated with hay fever and asthma and children with asthma and eczema are frequently the worst asthma patients among childhood asthmatics. Sometimes food allergies play an important role in eczema and will cause the rash to increase drastically after eating a certain food. The most common foods include egg, peanut, milk, fish, soy and wheat. These six foods account for 90% of positive food challenges in several large studies. The best way to tell if a food is involved is to eliminate it from the diet for about 2 to 3 weeks and then give the food in a doctor's office and observe for increase in symptoms. These could occur immediately or be delayed by several hours. Any foods found to flare up the eczema should be avoided in the diet for several months and possibly years before retrying them in a challenge test. Some children clear up once the offending food is removed from the diet and require no further therapy. In most cases, however, it is not that easy and ongoing treatment for the condition is required. Since eczema tends to be a lifelong disease which waxes and wanes it is helpful to understand the disease and the steps to control it. The three basic steps of controlling it include:

1. Controlling the itch

2. Hydrating the skin

3. Treating the inflammatory changes in the skin.


Next week: More details on the 3 steps to control eczema.