ATOPIC DERMATITIS Atopic dermatitis may start in infancy as a dry itchy skin rash with patches scattered all over. This infantile pattern changes to a more "Classic Pattern" as the child grows. The folds of the arms, neck, under the ears, behind the knees develop a rash that itches. It might be best to say it's an "Itch that Rashes" since the itching and scratching make it worse. Internal causes such as food allergies may be the initial trigger of the rash but later environmental allergies such as dust and grass may be a major factor. Dry skin is also a major component. Some allergy journals have suggested the chromosomes for dry skin and atopic dermatitis are closely associated. Currently, it is clear that the deficiency in the production of a protein called fillagrin, predisposes our development of Atopic Dermatitis. As it occurs,in nasal or ocular allergies, Atopic Dermatitis represents the expression of an allergic process using the skin as the target organ. Usually symptoms clear up considerably in children by the time they are 2 or 3 years old, however it is not unheard of to treat an adult patient who has had atopic dermatitis since childhood. Atopic Dermatitis has no age limit on who it can affect. Children and adults alike may be affected. Children with atopic dermatitis are at greater risk of developing asthma as the severity of their allergies increases. On a positive note, however, children with atopic dermatitis seem to have less severe symptoms as they mature. Signs & Symptoms: Infants present with red, scaly, oozy, crusty cheeks, and the neck, arms, and legs may be involved. In older children, the folds on the arms, behind the knees and the neck can become dry, thick, scaly, and very itchy. In young adults, symptoms typically appear on the face, neck, hands, feet, fingers, and toesOld lesions are thickened, leathery, dull-looking with darker color. Treatment: Moisturizers / Emollients Avoidance of known allergens Corticoid Steroid Creams Oral Corticoid Steroid Medications Anti-Itch Creams Oral Antihistamine Calcineurin inhibitors (pimecrolimus and tacrolimus) Wet dressings Phototherapy