Atopic dermatitis (or atopic eczema)

Abstract

Atopic dermatitis (AD) is a chronic relapsing, and severely pruritic skin disorder. AD is considered one of the major public health problems in the world, and its prevalence is increasing, especially in industrialized countries. This report contains updated knowledge on AD, its epidemiology, and current diagnostic and management approaches. There are approximately 10-20% of children and 1-3% of adult population affected worldwide. According to the International Study of Asthma and Allergies in Childhood (ISAAC), AD is most prevalent in developed and westernized countries. In most western countries, AD diagnosis is made by considering a number of clinical features (Fig. 3.1) and patient's history, classified into two categories, major and minor criteria, a system developed by Hanifin and Rajka in the 1980s. Sometimes, AD diagnosis is challenging, given the similarities in clinical features with other conditions. The disease severity is estimated using a number of scoring systems, of whom SCORAD is the most commonly used. It takes into account the intensity of each of the five AD skin lesions (redness, swelling, oozing/crusting, scratch marks, lichenification), in addition to pruritus (itch) and sleeplessness, and also the area of affected body parts. With the rising AD incidence and its familial association, new prophylactic strategies are being investigated. Currently, emollient and probiotic preparations provide a new hope in AD prevention in individuals at risk. Bacterial (Staphylococcus aureus) and viral (herpes simplex) infections are the most prevalent in complications. These complications may justify the use of anti-allergic agent combined with an antibiotic or antiviral drug in some AD patients, in addition to conventional anti-allergic drugs. Finally, most commonly used conventional AD treatment agents are presented in this work.