Atopic Dermatitis in Childhood and Adolescence: 15 (Pediatric and Adolescent Medicine)

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Steroids, if overused, are potentially damaging to the skin. Follow the advice of your child's doctor. These medications are derived from mold or bacteria and slow the growth of specific microorganisms. A sample from the body part thought to be infected may be taken and cultured in a lab to determine what type of antibiotic to use for the most effective treatment.

This medication is used primarily to prevent rejection after organ transplantation.

It suppresses the immune system and has other side effects that should be considered. It is safest to have this treatment under medical supervision, but light therapy is not offered at all dermatology clinics. Home light therapy devices are available, but may not be covered by insurance. Narrow band UVB ultraviolet B light units are the most effective. Be sure to follow the manufacturer's instructions carefully to avoid injury. Topical immunomodulators are a new class of drugs for the treatment of eczema. These drugs are applied directly to the skin to alter the immune response.

Atopic Dermatitis in Cameroon: Atopic Dermatitis and Psychiatric Impairments. The dearth of Cameroonian data on the quality of life QoL of patients with atopic dermatitis AD prompted this study which aimed to assess the impact of AD on QoL of affected children and adolescents as well as their families, and seek existence of psychiatric comorbidity depression and anxiety.

Standardized scores and scales were used to assess the severity of the disease, the QoL of patients and families, as well as the presence of depression or anxiety. A total of 53 children were recruited. The median age was 60 months. QoL was impaired in QoL of the family was impaired in There were 5 teenagers with mild depression, 2 with mild anxiety, and 1 with moderate anxiety. Atopic dermatitis AD is a chronic, relapsing inflammatory skin disease which may be associated with respiratory allergies such as asthma or allergic rhinitis [ 1 ].

AD begins in early childhood, period during which the most severe forms are seen. Pediatric incidence of this disease varies from 2. The cardinal signs of AD are pruritus, xerosis and evolution with repeated flares [ 6 ].

The intensity of pruritus causes patients to regularly scratch themselves [ 7 ]. When the pruritus is very intense, it can cause difficulties in falling asleep or lead to repetitive awakenings, resulting in an irritability which sustains the stress caused by the disease; eventually, quality of life QoL of children and parents may deteriorate [ 8 ]. Several studies have found a significant association between severity of AD and QoL [ 9 , 10 ].

Although subjects with AD show no specific psychological disturbances, sometimes they are anxious and the disease interferes in their relationships with their entourage, which can lead to withdrawal [ 11 ]. The impact of AD on QoL is an important element often overlooked by practitioners. Direct effects such as sadness, inertia and depression are often seen in children who have the condition [ 12 ]. However, impaired QoL can integrate the guilt of parents for not being able to control flares in their children and sibling rivalry because the focus is more on the ill child.

This may be a constant source of psychological stress for the entire family. In Cameroon, particularly a sub-Saharan African country , there is to date and to the best of our knowledge no study on this subject. It is in this context that we conducted the present study with the aim of assessing the impact of AD on QoL of patients and their families, and investigate the existence of psychiatric comorbidities depression, anxiety.

We used a questionnaire to collect information, namely demographics age, gender, level of education of the child and parents, type of home, level of cleanliness and environment, profession of parents, size of the family , history of the disease, and family history. These assessments were conducted using preestablished and standardized scores and scales.

According to this index, AD is classified into mild, moderate and severe for indices between "", "" and "" respectively. Parents answer questions about the child's illness over the course of the week before consultation.

This scale consists of 10 items and each item is scored from 0 to 3. The IDQoL is calculated by adding the score of each question. The total varies from 0 to 30 points; the higher the score, the more QoL is impaired. Patients answer questions about their illness during the previous week.

Atopic Dermatitis in Children

It consists of 10 elements and each element is rated 0 to 3. In our study, the questionnaire was given to children 5 to 16 years. It is completed by the parent or guardian. DHEA might antagonize the Th2 cytokines release, but the role of testosterone and other androgens has not been clarified yet. In most cases, patients with AD improve or recover during childhood.

Atopic Dermatitis in Children

The typical eczematous lesions appear mainly during the first two years of life with a different distribution depending on the age of the patients. During the first months of life lesions are exudative and mainly localized in the head, face in particular forehead, cheeks, chin, with the central-face saving and in the extensor surfaces of limbs. In older children the lesions are mainly concentrated on the flexural surfaces of the limbs, the popliteal and antecubital folds, back of hands and feet.

The skin is commonly dry with lichenification and intense itch; the lips are frequently dry brittle, chapped and develop fissures.

A post-inflammatory hyperpigmentation is frequently found in the region around the eyes. The evolution of the clinical feature is characterized by phases of remission of symptoms, which occur mostly during the summer months, alternating with periods of exacerbation, particularly during the autumn-winter.

The early onset, the severity of the framework, frequent relapses and chronic course make a disease with important psychological consequences that affect the quality of life QoL of the children and their families. Affected children often present behavioral problems, mainly characterized by increased emotional dependency, anxiety, and sleep disturbances.

The itching, which is one of the main symptoms of the disease, affects mood and sleep quality of patients and consequently of their family. The chronic course characterized by remission and exacerbation and the long-term treatments, negatively affects the quality of family life, both economically and psychologically, producing anxieties, frustrations, creating feelings of guilt and anger. Adolescents with AD exhibit greater vulnerability, anger, anxiety, insecurity, but few studies have been done about it.

What is atopic dermatitis?

A recent study 21 study of American adolescents suffering from atopic diseases has highlighted the existence of a significant association between increased levels of anxiety and the presence of allergic respiratory diseases asthma and RC but not with the AD; in this study it seems that AD affects the QoL in general terms of itching, and sleep disturbance, but it is subjectively experienced by patients as less severe than respiratory diseases.

A study by Brenninkmeijer et al.

What is atopic dermatitis?

AD had a highly negative impact on patient QoL in the A study by Saunes et al. In particular, the prevalence of psychological distress was highest in the largest age group 17—19 years.

Sang Ho et al. The basis of therapy for the management of AD in adolescents are similar to those of younger child. It may be noted that the adherence to therapy, which often must be at least daily for prolonged periods, is certainly more difficult for the adolescents. To encourage this therapeutic compliance in adolescents, a recent study 25 conducted in the U. The need to create an educational and training program to educate, inform and support families with children affected by AD in the management of this disease originates the concept of the School of atopy, on the model of the first educational program initiated in Germany: The Schools of atopy are differently structured, depending on different countries, although in general the standard provides, in addition to a coordinator or leader, a dermatologist, a pediatrician, an allergist and a clinical psychologist, to which other figures can be added.

A study by Ricci et al.

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