Atopic dermatitis

Lore & Background

Atopic dermatitis is a multifactorial disease with no known exact cause, believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with skin permeability. If one identical twin is affected, the other has an 85% chance of having the condition. Those living in cities and dry climates are more commonly affected, and exposure to certain chemicals or frequent hand washing makes symptoms worse. Emotional stress may worsen symptoms but is not a cause, and the disorder is not contagious.

Reader's Guide

Atopic dermatitis is significant as one of the most common chronic skin conditions, affecting about 20% of people at some point in their lives. Its impact extends beyond the skin, as many people with AD develop hay fever or asthma. The condition typically begins in childhood and can vary in severity over the years, with affected areas changing as the person ages: in infants, the face, limbs, and much of the body may be affected; in older children, the insides of the knees, folds of the elbows, and around the neck are common; in adults, the hands and feet are commonly affected.

Treatment focuses on avoiding triggers, enhancing the skin barrier with moisturisers, and controlling inflammation with corticosteroid creams or calcineurin inhibitors. More severe cases may require systemic medicines such as ciclosporin, methotrexate, dupilumab, or baricitinib. The condition is not contagious, and dietary exclusion is only needed if food allergies are suspected.