Atopic dermatitis is a very frequent reason for consultation in our pediatric dermatology offices. It occurs because the lack of some proteins in the skin, which function as a “cement”, allows many external elements (cold or other factors) to irritate or attack the skin, causing the lesions of the dermatitis.
At the beginning, atopic dermatitis manifests itself in the form of reddish, oozing lesions on the cheeks or on the outer face of the arms and legs. With the passage of months or years, these move to the fold areas and become more scaly. In any case, the most important characteristic of the disorder is the intense itching associated with the lesions, which impairs the quality of life of affected patients and their families. This itching forces scratching or, in the case of very young children, pinching of the skin.
Treatment of atopic dermatitis
The treatment of atopic dermatitis must be individualized. Although it is true that to date there is no definitive cure for the disease, we can learn to recognize and mitigate its outbreaks, and to carry out maintenance treatment to avoid rapid relapses.
In outbreaks with few lesions, topical treatment is usually sufficient, which is mainly based on the use of corticosteroids, applied to the lesions for a limited time indicated by the dermatologist or pediatrician. For maintenance, two topical immunomodulators (tacrolimus and pimecrolimus) are used, which can be used long-term and without rest periods without suffering the adverse effects associated with the chronic and constant use of a corticosteroid.
Topical treatments may be insufficient in patients with multiple lesions and a lot of symptomatology. In these cases it may be necessary to use oral treatments, such as oral corticosteroids in short cycles associated with local treatment. If the disease is not well controlled, other treatments include phototherapy and immunosuppressive treatments such as cyclosporine.