The intersection of atopic dermatitis, under-diagnosis and confusion with other diseases

Intense and almost intolerable itching seems to be the most accurate and recurrent description of patients who are suffering and suffering Atopic dermatitis (AD). In turn, the description alone appears to be part of a common skin disorder, which further complicates matters as it removes it from accurate and early diagnosis.

Sometimes patients with AD are confused – and the worst is that they are treated – with diseases such as Prurigo, psoriasis, scabies or drug reactions.

Atopic dermatitis is a chronic disease generated by the immune system, systemic, incurable and visible on the skin., with the cumulative potential for significant debilitating effects on patients' quality of life.

"AD has multiple faces depending on the age of the patient, but its main symptom is pruritus with extremely dry and reactive skin," said Dr. Cristina Pascutto, dermatologist and current president of the Argentine Dermatology Society ( SAD). .

For the same inflammatory process of the skin, 7 out of 10 patients also have other diseases (comorbidities) such as asthma, rhinitis and allergic conjunctivitis, chronic rhinosinusitis, nasal polyps and food allergies.

For 6 out of 10 adults with the moderate to severe variant, itching is intense or intolerable.

There is consensus and support between two Argentinean scientific societies to raise public awareness of this skin-affecting disease. In this regard, the Argentine Association of Allergy and Clinical Immunology (AAAeIC) and the Argentine Society of Dermatology (DAS) have combined their knowledge and information in the framework of World Day of Atopic Dermatitis, which is commemorated today, November 27th.

AD is generally considered a condition of childhoodbecause it affects between 5 and 20% of children, 10 to 40% of whom have the severe form. Be that as it may, in 3 out of 10 cases, it persists after puberty and, in fact, some patients even show the first symptoms only in adults.

"Some people scratch themselves asleep or try to sleep, it's hard for parents who see their child to suffer or for a man or woman to see their partner in this situation." Whatever it is, the one who did it is the one who has his life crossed by itching, rashes, redness and pain, "said the doctor Gabriel Gattolin, President of the Allergy and Clinical Immunology Association of Argentina (AAAeIC).

"When the patient comes for the first time to the clinic, he is asked if he has any manifestation of the airways, is asked about the family history and, of course, confirms the existence of lesions. skin or skin extremely serious dry, "said the specialist Pascutto.

Gattolin acknowledged that "the pruritus of the patient is the main reason for seeking consultation, however, red, swollen, cracked, thick, oozing skin is complex, often severe, and difficult to treat."

In this condition, there is what is called a cycle between the itch and the act of scratching, which generates even more itching. In the first case, the cells of the immune system send signals to ignite the surface of the skin, which stings it. When you scratch, the superficial barrier of the skin is broken, allowing the entry of viruses, bacteria and allergens. This, in turn, reactivates the cells of the immune system, which send signals that produce more itching, redness and rashes.

Some factors contribute to the onset of epidemics and should be avoided: The stress
– Food allergens (egg, milk, wheat, soy, peanuts, others)
-Aerallergens (mites, weeds, animal epithelia, fungi, others)
-Irritans such as skin cleansers, woolen garments or synthetic fibers
-Hot water
-Sodium soap and aggressive detergents
– Climate with extreme temperatures, humidity or excessive drought
-Infections of the skin by some microorganisms

How to treat it, how to deal with it

SAD noted that the most important recommendation wasits in the care of the skin and the control of the dry skin, by restoring the cutaneous barrier thanks to the use of hygiene products and emollients adapted and specific to this type of skin, for thus avoid scratches, exacerbation of injuries and superinfections.

It is a multifactorial disease in which the treatment must aim to improve the skin barrier (skin integrity), to avoid dehydration and to treat inflammation.

Compounds and foods containing oats also help, since it is a natural anti-inflammatory for the skin. Ultraviolet rays work together, so it is recommended to expose to the sun, but before 10 or after 18 hours, because the most abrasive rays can dehydrate the skin and affect its effectiveness.

"The development of new drugs to inhibit the processes that trigger inflammation, with a good safety profile, opens up promising prospects for the future," said medical dermatologist Pascutto.

Some figures with which they shared Infobae SAD and AAAeIC are used to measure the severity of this condition and its direct impact on the daily life of this inflammatory skin disease.

Itching occurs day and night, 8 out of 10 patients with moderate to severe atopic dermatitis suffer from sleep disorders and more than half said their itching prevented them from sleeping 5-7 nights a week.

Those who suffer Moderate to severe ADs are absent from work, three times more than the rest of the population. On average, adolescents lose 26 days of classes per year for this condition, at 3.5 days per episode. During an outbreak of exacerbation, half (50%) of adolescents reported that they had guarantees to be seen in public and 36% lost confidence in themselves.