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REPORTED BY: PAUL WILLIAM MELENDEZ

p Also known as ³eczema,´ atopic dermatitis is a
chronic (long-
(long-lasting) skin condition. It causes
dry, itchy, irritated skin that can require daily
care. Most people (90%) develop atopic
dermatitis before age 5.
p Atopic dermatitis is not contagious, so there is
no need to worry about catching it or giving it to
someone. This skin condition tends to run in
families. People who get atopic dermatitis
usually have family members who have
eczema, asthma, or hay fever.
p v
v

p Extremely itchy patches of skin. The skin may not always itch. The itch
can come and go.

In infants, these patches tend to develop on the scalp and face,

especially on the cheeks. Teens and young adults are more likely to see
patches on their hands and feet. Other common sites for these patches
are the bends of the elbows, backs of knees, ankles, wrists, face, neck,
and upper chest. The patches may not always appear in these areas;
they can occur anywhere on the skin, including around the eyes and on
the eyelids.

p Rash. This often appears after the itchy skin is scratched or rubbed, but
not always. A rash can occur even when the skin is not scratched.

p Skin can swell, crack, ³weep´ clear fluid, crust, and scale.

p Patches may bubble up and ooze or be scaly, dry, and red.

p Without proper treatment, the skin thickens to protect itself from further
damage caused by scratching. Dermatologists call this thickening of the
skin ³lichenification.´
p ã 
While the cause of atopic dermatitis is not fully understood,
researchers believe a complex interaction of several factors
² the genes we inherit, where we live, a breakdown of the
outermost layer of skin, and a malfunctioning immune system
² leads to atopic dermatitis.

? 

The following appear to increase one¶s risk:
p   
 A family history of atopic (tendency for excess
inflammation in the skin, linings of the nose, and lungs) conditions,
such as atopic dermatitis, asthma, or hay fever. This remains the
strongest risk factor. If one or both parents have a history of atopic
dermatitis or an allergic condition, the child is much more likely to
develop atopic dermatitis.

p       Living in a developed country, urban area

(especially one with higher levels of pollution), or northerly part of the
world seems to increase the risk. For example, Jamaican children
living in London are twice as likely to develop atopic dermatitis as are
Jamaican children living in Jamaica.
p

p m
 Appears before 1 year of age in 65% of people; 90% develop

before reaching 5 years of age.

p D   Females are slightly more likely than males to develop.

p O
 


   Atopic dermatitis tends to be more
common when the mother gives birth to a child later in her
childbearing years.

p ÷  During the last 40 years, a steadily increasing number of

people worldwide, mostly children, have developed atopic dermatitis.
In the United States alone, the prevalence of atopic dermatitis in
children born after 1980 has increased by 15% to 20%. This equals a
3- to 4
4--fold increase over the 5% prevalence rate reported during the
1950s in school-
school-age children.

p v  Atopic dermatitis tends to be more common in higher

social classes.

p     Atopic dermatitis tends to be more common in immediate

families that are smaller in size.
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p Dermatologists look for a rash. They ask about

itching, the patient¶s medical history, and the
medical history of close blood relatives. The
patient is more likely to have atopic dermatitis if
there is a history of atopic dermatitis, asthma, or
hay fever.

p Patch testing, a medical test used to find

allergies, may be conducted to learn if the
patient has allergic contact dermatitis (another
common type of eczema).
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p While atopic dermatitis cannot be cured,

most cases can be controlled with
proper treatment. The goals of treatment
are to hydrate the skin, reduce
inflammation, decrease the risk of
infection, and alleviate the itchy rash.
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›
p  
 

 
p   

p eep the area clean and prevent infection to avoid further
complications.
p Provide an environment that are free of dust and allergens
that may further irritate the client to achieve better
Outcome
p Cut child¶s nails as necessary to avoid further scratching
that may cause lesions.
p eep the area clean and dry to assist body¶s natural
process of repair.
p Administer prescribed medications(Bactroban Cream) on
time to alleviate the condition.
p Apply chalamine lotion to decrease itching.
p Consult with wound specialist to assist with developing
plan of care for potentially serious wounds.
m
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p A diaper rash is a skin problem
that develops in the area
beneath an infant's diaper
 ãm

p Diaper rashes are common in babies between 4 and 15 months
old. They may be noticed more when babies begin to eat solid
foods.
p Diaper rashes caused by infection with a yeast or fungus called
Candida are very common in children. Candida is found
everywhere in the environment. It grows best in warm, moist
places, such as under a diaper. A yeast-
yeast-related diaper rash is
more likely to occur in babies who:
p Are not kept clean and dry
p Are taking antibiotics, or whose mothers are taking antibiotics
while breast feeding
p Have more frequent stools
p Other causes of diaper rashes include:
p Acids in the stool (seen more often when the child has diarrhea)
p Ammonia (produced when bacteria break down urine)
p Diapers that are too tight or rub the skin
p Reactions to soaps and other products used to clean cloth diapers
p Too much moisture
  

p You may notice the following in your child's diaper
area:
p Bright red rash that gets bigger
p Fiery red and scaly areas on the scrotum and penis
in boys
p Red or scaly areas on the labia and vagina in girls
p Pimples, blisters, ulcers, large bumps, or pus-
pus-filled
sores
p Smaller red patches (called satellite lesions) that
grow and blend in with the other patches
p Older infants may scratch when the diaper is
removed.
p Diaper rashes usually do NOT spread beyond the
edge of the diaper.
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p Yeast or Candida-
Candida-related diaper rashes
often can be diagnosed by the
appearance alone. The OH test can
confirm a Candida diagnosis.
›

p The best treatment for a diaper rash is to keep the diaper
area clean and dry. This will also help prevent new diaper
rashes.
p Always wash your hands after changing a diaper
p Ask your doctor if a diaper rash cream would be helpful. Zinc
oxide or petroleum jelly-
jelly-based products help keep moisture
away from baby's skin when applied to completely clean, dry
skin
p Avoid using wipes that have alcohol or perfume. They may
dry out or irritate the skin more
p Do NOT use corn starch on your baby's bottom. It can make
a yeast diaper rash worse
p Do NOT use talc (talcum powder). It can get into your baby's
lungs
p Change your baby's diaper often, and as soon as possible
after the baby urinates or passes stool
p Pat the area dry or allow to air-
air-dry
p Lay your baby on a towel without a diaper on whenever
possible. The more time the baby can be kept out of a diaper,
the better
p Put diapers on loosely. Diapers that are too tight don't allow
enough air and may rub and irritate the baby's waist or thighs
p Use water and a soft cloth or cotton ball to gently clean the
diaper area with every diaper change. Avoid rubbing or
scrubbin the area. A squirt bottle of water may be used for
sensitive areas
p Using highly absorbent diapers helps keep the skin dry and
reduces the chance of getting an infection
p If you use cloth diapers:
p Avoid plastic or rubber pants over the diaper. They do not
allow enough air to pass through
p Do NOT use fabric softeners or dryer sheets. They may make
the rash worse
p When washing cloth diapers, rinse 2 or 3 times to remove all
soap if your child already has a rash or has had one before
p MEDICATIONS:
p Topical antifungal skin creams and
ointments will clear up infections caused
by yeast. Nystatin, miconazole,
clotrimazole, and ketaconazole are
common ones.
p Sometimes a mild, topical corticosteroid
cream may be used. Talk to your doctor
before trying this on your baby.