Are you afraid of contagion when shaking hands? He suffered from "atopic dermatitis" and was bullied, and his job search was blocked! Doctor: The earlier the treatment, the better the control effect.
What is atopic dermatitis? Are seasonal changes more likely to cause attacks?
Dr. Luo Yang, a dermatologist at Neihu Cathay Clinic, said that atopic dermatitis can be regarded as a “congenital allergic genetic disease” and is related to the body’s immune system. Some patients have congenital genes that cause the stratum corneum to lack the ability to retain water. Coupled with acquired environmental allergens and food irritation, the symptoms are significantly aggravated. Symptoms may also become more severe during seasonal changes in summer and winter.
Dr. Luo Yang said that the prevalence of atopic dermatitis is mostly among children. About 60% will develop symptoms before the age of 1, and 85% of patients will develop symptoms before the age of 5. There are also differences in the location of the lesions. Atopic dermatitis in infants mostly occurs on the scalp and deep sides of the limbs; in adults, it mainly occurs in folds such as elbows and knee sockets.
Dr. Luo Yang pointed out that in adult patients with atopic dermatitis, those with higher levels of “E immunoglobulin” (IgE) will be more difficult to treat and the treatment effect will be less ideal. The proportion of men with arthritis is 2 times higher than that of women, and there is no obvious gender difference in childhood and infancy.
Is atopic dermatitis more difficult to treat in adulthood? Is self-medication likely to cause serious problems?
Dr. Luo Yang said that when symptoms of atopic dermatitis occur, the sooner they are treated, the better the control effect will be. Some patients had lesions when they were young, and their parents may think it was just eczema and apply medicine themselves. However, when atopic dermatitis becomes more severe after middle school or high school, the effect of applying medicine will be even less satisfactory. Statistics have found that 3/4 of patients who develop atopic dermatitis before the age of 5 will gradually improve over time, and 1/4 will still have symptoms until adulthood.
For example, Dr. Luo Yang once treated a young patient with atopic dermatitis. Due to the large area of the lesion, he had to wear long sleeves and long pants every day before going out. During his military service, he was bullied because of the disease. After entering the society, he was bullied because of the large area of the disease. The redness, swelling and desquamation of the skin make it difficult to find a job. Even social movements such as shaking hands can cause the other party to fear infection due to skin desquamation. Most of these adult patients have high levels of E-immunoglobulin, and allergic reactions are caused by the environment and food, adding more troubles to their lives. Early medical treatment is recommended.
How is atopic dermatitis evaluated? What treatments are available?
The evaluation and diagnosis of atopic dermatitis is mainly based on the score of EASI (Eczema Area and Severity Index). Dr. Luo Yang explained that the judgment criteria include the thickness of the lesion, the degree of redness, swelling and desquamation. In more severe cases, “lichenification” may also occur. Scores are given for each skin condition to assess whether the condition is mild, moderate or severe.
Dr. Luo Yang explained that when atopic dermatitis progresses to moderate to severe severity, phototherapy and oral immunosuppressants can be used to reduce skin inflammation. Some patients can also achieve good control effects by using low-dose steroids, but there may be long-term consequences. Issues with side effects of use.
If the patient does not improve after 3 months of treatment with light and oral medications, and the lesions account for more than 10% of the body surface area, biological agents targeting inflammatory cytokines can be used. At present, more than 60% of patients can achieve 75% improvement in symptoms using biological agents.
Dr. Luo Yang reminded that oral immunosuppressants will affect blood cells, hemoglobin, white blood cell index, etc. Patients should draw blood regularly for monitoring in the early stage of treatment. Certain types of drugs can affect liver and kidney function. All these need to be considered based on the drug use and the patient’s condition. Patients with atopic dermatitis who have hepatitis B should avoid the use of immunosuppressants metabolized by the liver.
Daily care for atopic dermatitis? How to avoid scratching makes it more itchy?
During the epidemic, should patients with atopic dermatitis pay special attention when receiving the COVID-19 vaccine? Dr. Luo Yang said that before patients with atopic dermatitis are vaccinated, they must temporarily stop taking the medicine depending on the type of oral medicine they are currently taking. It is also necessary to consider whether immunosuppressants and other drugs will affect the side effects of the vaccine, so you should consult the attending physician before taking the vaccine.
Some patients are worried about whether they need to draw blood to detect allergens to avoid atopic dermatitis from getting worse? Dr. Luo Yang explained that allergen detection is more suitable for moderate to severe patients, while daily care is the main focus for patients with average levels. Patients with atopic dermatitis are reminded that if they need to bathe in hot springs in winter, they must moisturize as soon as possible after bathing.
Dr. Luo Yang reminds that “moisturizing” is the most important key to daily care for atopic dermatitis, and avoiding dry skin and scratching. Scratching will cause the stratum corneum to secrete inflammatory cytokines and aggravate the symptoms. Therefore, applying lotion and moisturizing must not be omitted. Especially for male patients, do not neglect moisturizing because the skin is too oily, otherwise the skin will become redder and darker as it gets scratched. A vicious cycle of scratching and getting itchy.
In addition, the itching of atopic dermatitis will affect the quality of sleep. Dr. Luo Yang explained that antihistamine drugs can be intervened in time to control the itching problem. Non-steroidal immunosuppressant ointments also have a certain effect, but the burning and stinging sensations are more obvious, so the appropriate medicine must be prescribed according to the lesion. Doctors remind you that if you have any suspicion of atopic dermatitis, you can consult a dermatologist for advice and take corrective treatment as soon as possible.
