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Concept
Atopic dermatitis
Summary
Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which can thicken over time. AD may also simply be called eczema, a term that generally refers to a larger group of skin conditions.
Atopic dermatitis affects about 20% of people at some point in their lives. It is more common in younger children. Females are slightly more affected than males. Many people outgrow the condition.
While the condition may occur at any age, it typically starts in childhood, with changing severity over the years. In children under one year of age, the face and limbs and much of the body may be affected. As children get older, the areas on the insides of the knees and folds of the elbows and around the neck are most commonly affected. In adults, the hands and feet are commonly affected. Scratching the affected areas worsens the eczema and increases the risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.
The cause is unknown but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin. If one identical twin is affected, the other has an 85% chance of having the condition. Those who live in cities and dry climates are more commonly affected. Exposure to certain chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse, it is not a cause. The disorder is not contagious. A diagnosis is typically based on the signs, symptoms and family history.
Treatment involves avoiding things that make the condition worse, enhancing the skin barrier through skin care and treating the underlying skin inflammation. Moisturising creams are used to make the skin less dry and prevent AD flare-ups. Anti-inflammatory corticosteroid creams are used to control flares-ups. Creams based on calcineurin inhibitors (tacrolimus or pimecrolimus) may also be used to control flares if other measures are not effective.
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Moisturizer
A moisturizer, or emollient, is a cosmetic preparation used for protecting, moisturizing, and lubricating the skin. These functions are normally performed by sebum produced by healthy skin. The word "emollient" is derived from the Latin verb mollire, to soften. In the human body, water constantly evaporates from the deeper layers of the skin through an effect known as transepidermal water loss (TEWL). By regulating its water content, human skin naturally maintains a dry, easily shed surface as a barrier against pathogens, dirt, or damage, while protecting itself from drying out and becoming brittle and rigid.
Atopy
Atopy is the tendency to produce an exaggerated immunoglobulin E (IgE) immune response to otherwise harmless substances in the environment. Allergic diseases are clinical manifestations of such inappropriate, atopic responses. Atopy may have a hereditary component, although contact with the allergen or irritant must occur before the hypersensitivity reaction can develop (characteristically after re-exposure). Maternal psychological trauma in utero may also be a strong indicator for development of atopy.
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Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given.