Atopy refers to the predisposition to develop asthma, hayfever and an associated skin disorder appropriately called “atopic dermatitis” and referred to by many people as “eczema”.
The surface where the body contacts the external environment may be thought to be “over reactive” and in two thirds of cases, there is a mutation in the gene which “glues” the skin cells together.
Atopic dermatitis is an itch, which, when scratched, erupts. The most common irritants which can exacerbate atopic eczema is excessive washing without enough moisturizing, harsh soaps containing sodium laurel sulfate and fragrances, as well as topical irritants including wool, synthetic fabrics and solvents.
In our practice, emphasis is put on patient education. Without an understanding of the pathogenesis of eczema, patients get frustrated with repeated flares. Time needs to be spent on carefully looking for potential triggers, emphasizing the essential need of applying an artificial barrier to the skin and only then addressing the medical management of this condition which is distressing for not only the patient but often the wider family.
In addition to the traditional methods of treating eczema including topical corticosteroids, calcineurin inhibitors, Staphylococcus aureus eradication and in severe cases even oral medications or phototherapy, we will also explore the contribution of gut health and ensure all topicals applied to the skin are “clean” and non-toxic. We hold our patients’ hands tightly through the decision-making process and make sure that they are fully empowered to move up and down their ladder of treatment depending on whether they are in the active treatment or maintenance phases of their management plan.
Allergy Foundation of South Africa
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