Atopic Dermatitis (cont.)
Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Atopic dermatitis facts
- What is atopic dermatitis?
- What is the difference between atopic dermatitis and eczema?
- How common is atopic dermatitis?
- What causes atopic dermatitis?
- Is atopic dermatitis contagious?
- What are atopic dermatitis symptoms and signs?
- Can atopic dermatitis affect the face?
- What are the stages of atopic dermatitis?
- How do physicians diagnose atopic dermatitis?
- What factors can aggravate atopic dermatitis?
- What are skin irritants in patients with atopic dermatitis?
- What are allergens?
- What are aeroallergens?
- What is the treatment for atopic dermatitis?
- What is the prognosis of atopic dermatitis?
- Find a local Dermatologist in your town
What are allergens?
Allergens are substances from foods, plants, or animals that provoke an overreaction of the immune system and cause inflammation (in this case, the skin). Inflammation can occur even when the person is exposed to small amounts of the allergen for a limited time. Some examples of allergens are pollen and dog or cat dander (tiny particles from the animal's skin or hair). When people with atopic dermatitis come into contact with an irritant or allergen to which they are sensitive, inflammation-producing cells permeate the skin from elsewhere in the body. These cells release chemicals that cause itching and redness. As the person scratches and rubs the skin in response, further damage occurs.
Certain foods occasionally may act as allergens and trigger atopic dermatitis or exacerbate it (cause it to become worse). Food allergens clearly play a role in a small number of cases of atopic dermatitis, primarily in infants and children. An allergic reaction to food can cause skin inflammation (generally hives), gastrointestinal symptoms (vomiting, diarrhea), upper respiratory tract symptoms (congestion, sneezing), and wheezing. The most common allergy-causing (allergenic) foods are eggs, peanuts, milk, fish, soy products, and wheat. Although the data is not compelling, some studies suggest that mothers of children with a family history of atopic diseases should avoid eating commonly allergenic foods themselves during late pregnancy and while they are breastfeeding the baby. Although not all researchers agree, most experts think that breastfeeding the infant for at least four months may have a protective effect for the child. New lines of evidence even support exposing young children to normal environmental contaminants such as peanuts. Although such exposures may prevent the development of atopic dermatitis, there is no consensus on how to prevent the development of atopic diseases.
If a food allergy is suspected, it may be helpful to keep a careful diary of everything the patient eats, noting any reactions. Identifying the food allergen may be difficult and require supervision by an allergist if the patient is also being exposed to other allergens. One helpful way to explore the possibility of a food allergy is to eliminate the suspected food and then, if improvement is noticed, reintroduce it into the diet under carefully controlled conditions. A two-week trial is usually sufficient for each food. If the food being tested causes no symptoms after two weeks, a different food can be tested in like manner afterward. Likewise, if the elimination of a food does not result in improvement after two weeks, other foods may be eliminated in turn.
Changing the diet of a person who has atopic dermatitis may not always relieve symptoms. A change may be helpful, however, when a patient's medical history and specific symptoms strongly suggest a food allergy. It is up to the patient and his or her family and physician to judge whether the dietary restrictions outweigh the impact of the disease itself. Restricted diets often are emotionally and financially difficult for patients and their families to follow. Unless properly monitored, diets with many restrictions can also contribute to nutritional problems in children.
Next: What are aeroallergens?
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