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Although atopic dermatitis can appear at any stage of life, it predominates in children under 7 years of age. The so-called infant dermatitis - up to 24 months - has a predilection for the cheeks, the folds of the elbow, the cuffs, the back of the hands and the chin.
Between the ages of 2 and 14, it migrates to locate itself in the flexion folds: neck, armpits and groin. Later it manifests itself mainly in the mouth, eyelids and the back of the hands.
The symptom that sets off the alarm bell is an intense and exasperating itch which significantly alters sleep and quality of life, even inducing anorexia.
Another symptom is whitish and slightly scaly areas of a rounded or oval shape on the face, upper part of the trunk and the outer surface of the extremities. And scabs, dry skin, papules, peeling on the soles of the feet or between the toes and a double or triple fold in the eyelid area.
Its appearance is due to a genetic predisposition (if one of the parents suffers from it, the child has a 50 percent probability) and environmental factors (allergens, extreme temperatures ...). The substances most suspected of causing outbreaks are antihistamines, neomycin and sulfa drugs, as well as perfumes and certain preservatives or stabilizers. And many experts think that it is due to excess hygiene, which leaves the skin unprotected.
The prevalence has tripled in the last 30 years in industrialized countries and It is in summer when consultations are doubled because the lesions become more striking when contrasting with tanned skin. Plantar dermatitis in children and adolescents is also accentuated by the continuous rubbing of already predisposed skin against the sole of the shoe on feet overheated by the heat. And as it evolves through outbreaks, changes in temperature and place, and exposure to new environmental agents are aggravating.
There is no treatment that ensures the definitive cure of atopic dermatitis but, according to Dr. José Carlos Moreno, head of Dermatology at the Reina Sofía Hospital in Córdoba and vice president of the Spanish Academy of Dermatology, can be alleviated with correct hydration and shock treatment with corticosteroids. "Lately, a great reluctance to use topical corticosteroids has been observed on the part of patients, relatives and even non-specialist doctors and it is a serious error, because it is the best treatment," says Moreno.
'Topical immunomodulators and maintenance treatment during less severe flare-ups with calcineurin inhibitors also work. When these topical measures fail, there are very effective systemic treatments - corticosteroids, immunosuppressants, intravenous immunoglobulins and biological therapies, 'he adds.
Parallel to the maturation of the immune system, the outbreaks are spaced: there is the possibility of improvement around 2 years and spontaneous healing around 7, but the tendency to dry skin will be preserved. Around 10, in many cases the eczema disappears, but asthma can appear. The sun generally favors spontaneous remissions.
If there is a history of atopics in the family, it is preferable to breastfeed during the first months of the baby's life (the mother avoiding milk, eggs and fish) and to diversify foods as late as possible.
- abc.es.Teresa de la Cierva
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