Atopic dermatitis-(AD) -otherwise known as atopic eczema is an acute sub acute, or chronic relapsing skin disorder characterized by dry skin, pruritis, which leads to Scratching, and ultimately thickening of skin (lichenification). So an itch –scratch-itch cycle develops. Serum IgE usually increased.
Diagnosis is on clinical findings.
When infected there is a colonization of S aureus bacteria. Usually associated with personal/family history of atopy ie; allergic rhinitis, asthma, atopic dermatitis. The word atopy is from Greek and meaning is “strange." In general, we can call it as allergy.
Atopic dermatitis is more common in infants and children. By about 60 percent of cases, the first appearance is about the 2nd month, 30% of cases by about the age of 5, and 10% cases between 6 and 20 yrs. Adult onset is not rare.
Males are affected more than the females.
The inheritance pattern has not been fully ascertained, but 60% of the adults with AD had children with AD.
If both parents have AD, 80% of children will have AD.
Along with skin symptoms, there may be allergic rhinitis characterized by sneezing, nasal obstruction, rhinorrhoea, itching of conjunctiva, pharynx, and eyes with lachrymation. It may be seasonal when associated with pollen.
Site of predilection-flexures, forehead, face, front and sides of neck, wrist, dorsum of feet and hands are the common sites.
In severe cases, the distribution may be general.
But the sites may vary in age.
In infants and young children commonly involved, areas are face, side and back of neck, chest. These are the areas where infants and young children can easily scratch. So the diaper areas are usually spared.
But in older children and usual areas are the flexures like front of elbow, back of knees, hands.
In adults, commonest areas are hands and feet.
Dust mites, pollen exacerbate the disease.
There is a flare-up in winter as well as summer. Cotton clothing is the better choice, because wool, blankets, trigger the pruritis.
Stress, anger and frustration will trigger the AD, but it won’t as such cause the disease. If it is not properly managed the smooth day to day activities of the patients is usually affected.
Measures to take care and avoid dryness of skin.
Avoid frequent and prolonged bathing with soap
Use moisturizer after bathing
Avoid soaps in every bath
Use mild and non drying soaps
Avoid adding bath oil in the bath water
Investigations
Bacterial culture-S aureus is very common in the involved skin.
Blood studies- increased IgE, AEC.
MANAGEMENT
Advise the patient to avoid rubbing and scratching
Keep away from the triggering factors
Advice to use cotton clothing
In children and adult advice yoga to get rid of emotional stress.
Treat the infection
Homeopathic treatment
Scope of homeopathy in atopic dermatitis
Almost complete cure is possible under homeopathic treatment.
Since atopic dermatitis being a genetically mediated condition, external application will only help to suppress the disease but not complete cure. By using ointment and other external application the disease as per homeopathic view, will go deep inside and will manifest to some other form. So an anti-miasmatic or constitutional medicine is needed for the complete cure.
Main remedies are-
Sulphur, graphitis ,mezerium, ars alb, sepia, petroleum are usually the remedies.
For and to control allergic rhinitis ars alb, silica, allium cepa etc;
Along with medicine and precautionary measures as mentioned above is also needed for the complete cure.
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