GET ALLERGY & ASTHMA RELIEF TODAY
Board Certified Allergy And Asthma Specialists (For Children & Adults)
Eczema (Atopic Dermatitis) and Contact Dermatitis
Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It is a chronic skin condition thought to be due to the “leakiness” of the skin barrier, which causes it to dry out, itch, and become prone to irritation and inflammation by many environmental factors. Also, know as “the itch that rashes”. Up to 30% of children with moderate to severe eczema may have a food allergy that is contributing to their eczema. Unlike with urticaria (hives), the itch of eczema is caused by mediators other than histamine, so anti-histamines may not control the symptoms. Eczema is often linked with asthma, allergic rhinitis (hay fever), or food allergy. This order of progression is called the atopic dermatitis march.
Treatment For Eczema
Atopic dermatitis can be persistent. You may need to try various treatments over months or years to control it. And even if treatment is successful, signs and symptoms may return (flare). Some of the treatments available are:
- Daily hydration of the skin with a bath followed by skin cream (Soak and Seal)
- Wet Wrap Dressings
Medications:
- corticosteroid cream or ointment
calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) - phosphodiesterase 4 inhibitor — crisaborole cream
- antibiotic cream — if your skin has a bacterial infection
- A newer option for severe eczema. The Food and Drug Administration (FDA) has recently approved a new, injectable biologic (monoclonal antibody) called dupilumab (Dupixent). It is used to treat people with severe diseases who do not respond well to other treatment options.
ABOUT PATCH TESTING
Appropriate diagnosis and management of persistent eczematous conditions such as contact dermatitis are common challenges for the allergist. Patch testing attempts to reproduce the allergic reaction on the normal skin on the upper back of the patient.
Patch Testing for Proper Diagnosis of Contact Atopic Dermatitis
Contact allergen skin testing is a simple and objective scientific method available to physicians to augment the diagnostic process. Often, the patch test response is the crucial piece of information that allows for the early identification of the offending allergen(s) and confirmation of a diagnosis of Allergic Contact Dermatitis (ACD) and/or Irritant Contact Dermatitis (ICD). Once a diagnosis is achieved, the patient can then take appropriate action to avoid exposure to the allergen and, if possible, substitute non-allergenic agents.
The patches are applied and subsequently removed after 48 hours. The patch site continues to be read after 72 – 96 hours.
The diagnostic value of patch testing depends upon the choice of the test substance, the vehicle, the concentration, results in interpretation, and patient counseling. Patch tests are comprised of materials that occur in the home, work, and/or recreational environment.
Vallen Allergy & Asthma, PC, is a leading allergy and asthma specialty practice in Quincy, MA.
For over 32 years, the office has been serving children and adults in southern and southeastern Massachusetts.