ECZEMA | ATOPIC DERMATITIS


-
Eczema/ Atopic dermatitis (AD) is a chronic inflammatory skin condition
-
AD disproportionately affects African Americans compared to other races.
-
It can present with itchy reddish-purple, brown, dark, scaly, sometimes thicked patches and plaques anywhere on the body. Classic AD does occur on flexor surfaces. Darker-skinned patients tend to present with more "follicular prominence", small bumps on the trunk and extensor surfaces, thickened plaques and nodules, and dark patches.
-
AD is thought to be caused by the interplay between defects in skin proteins reducing the ability to hold on to moisture, autoimmunity, and environmental triggers (e.g. diet, pollution, smoking)
-
Management includes avoiding triggers, gentle skin care, frequent moisturization, topical anti-inflammatory agents (e.g. corticosteroids, calcineurin inhibitors phosphodiesterase 4 inhibitors), oral anti-inflammatory medications (e.g. cyclosporine, methotrexate), phototherapy, intravenous immunoglobulin, interferon-gamma, and biologics (dupilumab),
References:
- Ait-Khaled, N. et al., J. Allergy 2007, 62, 247
- Kaufman BP, et. al, Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment. Exp Dermatol. 2018 Apr;27(4):340-357