Dermatitis AtopicaDermatitis or eczema is atopic dermatitis, skin inflammation, characterized by scaly skin lesions with erythema, vesicles, oozing, cracking, scratching lesions and areas of thickened (lichenification), almost always itchy. These lesions appear at different stages in the form of plaques that can appear depending on age in the face, flexures of the extremities, or in various areas of the body, even in some patients the full extent of the skin (erythroderma).

The atopic dermatitis is presented in different forms and depending on the age distribution of the patient.

In the infant, before the first birthday of eczema lesions usually occur on the head (cradle cap), face respecting eyes, nose and mouth, skin or extended by the entire body. In this type of presentation is usually a fairly striking and intense but its prognosis is very good disappearing before 5 years.
In school-age children with eczema lesions predominate in the flexures of limbs, neck and the area behind the ears, sometimes with eczema lesions on the lips and eyelids.
Dermatitis Atopica

In adults there are two ways, one is due to the persistence of school children with eczema lesions predominantly flexural, and another appearance in the adult with disseminated lesions, erythrodermic often with great affection of the face and neck and tends to become chronic .
There are other minor forms of atopic eczema, such as:
Ptiriasis alba are white lesions on the skin scaly and dry skin, may appear on the face or distributed throughout the body.
Cheilitis atopic eczema are lesions on the lips cracking.
Pulpitis atopic appear scaly and cracking of the pads of fingers and toes.

Causes

Atopic eczema occurs more frequently in people with a history of allergic diseases in the family (rhinitis, asthma, conjunctivitis or eczema) also tend to have high IgE, characteristic of allergic patients.
This non-specific IgE can be high, ie is not an allergy to dust mites, pollen or food, or be specific to one or more of them.

This elevated IgE is usually set to inflammatory cells (mast cells and basophils) and to specific stimuli (food, dust mites pollens, etc …) or nonspecific (stress, temperature changes, humidity, skin irritants) cause the release of histamine accumulated inside the cells producing itching.
This intense itching begins the sequence of spontaneous lesions or secondary to scratching and thus forms eczema.

In patients with atopic eczema there is a decrease of immunity against certain skin infections why eczema is often secondarily infected and become chronic.

Symptoms

The characteristic symptoms of atopic eczema are:

Intense itching skin areas, mainly flexures of the extremities.
Dry, scaly skin.
Injury scaling eczema with erythema, vesicles, oozing, cracking, scratching lesions and areas of thickened (lichenification).
The distribution of injuries is the age of onset and severity of eczema as we have seen before.

Diagnosis

Once characterized as atopic eczema by family history of allergy in the family and the distribution and the characteristic symptoms of eczema, is about finding the underlying causes of allergy that produces histamine release.
Because the cause of histamine release is the fixing of the IgE to different allergens, it must conduct a study to determine the causes allergy.

In most cases shows the elevation of circulating total IgE in blood.
From here you must determine the possible specificity of food allergies (egg, milk, fish, fruits, vegetables, nuts, dust mites and pollens etc …), techniques for the determination of specific IgE (CAP RAST, etc …).

In addition, allergy testing can be performed on the skin prick test, or even by epicutaneos test.
The goal is to find specific allergic factors that cause the itch to exclude the patient’s environment, for it is sometimes checking the causal relationship through exclusion diets addition of food, ensuring the improvement and worsening by removing or adding food suspects .

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