Eczema in kids

Another name used in the medicine for eczema is atopic dermatitis. Since there isn’t a cure for this condition, the parents find it very difficult to treat their children with eczema.

Symptoms

The most distinctive symptom of eczema is a rash on the skin that is very itchy and annoying. Eczema rash usually starts when a child is small and can appear by the age of 5. Parents think that when the eczema rash goes away, it will not return, but it usually does. A dermatologist can diagnose eczema with the help of the appearance of an itchy rash.

If it appears in certain areas such as the forehead, cheeks, arms, and legs in smaller children, while in older children the typical areas include elbows, knees, and ankles, then a doctor may diagnose eczema.

In some cases, eczema can be misdiagnosed or confused with some other skin condition, but there are means by which a doctor can be sure that he is dealing with eczema, and they include the timing of the rash appearance and the pattern of when it flares up.

Prevention

You can help your child by keeping him away from the known triggers for eczema. In most cases, these triggers are bubble baths, dust mites, synthetic fabric, wool, etc. In the case that the triggers are unknown, the best possible thing is to keep your child’s skin moisturized, so that eczema flares are avoided. Your child’s skin will be moisturized if you give it a bath with lukewarm water and a neutral, mild soap once a day.

After the bath, gently rub moisturizer into the skin, and the skin will not be dry. The most effective moisturizer is a greasy ointment, including Vaseline and Aquaphor. There are some non-steroidal creams on the market that have proved to be successful as well.

Treatment

At the peak of eczema flares, you can treat your child with topical steroids and new non-steroidal medications (Elidel, Protopic). Note that these medications aren’t to be used for children under two years of age. Elidel and Protopic are used twice a day and are applied to the areas that are affected by eczema.

If you start to use them after the first signs of eczema, you can avoid eczema flares in your child. Antihistamines are also used in eczema treatment by providing relief with decreasing itching. There are some other, also effective methods of eczema treatment.

You should know that if your child has eczema, in the future it will outgrow it or have a milder form of it. In some cases, eczema may run in the whole family and be in a close connection with allergic-type disorders. If your child’s eczema doesn’t ease down over time, visit a pediatrician so that he can react promptly.

Atopic dermatitis (AD), also known as atopic eczema, is the most common chronic inflammatory skin disorder of childhood and is characterized by pruritus, dryness of skin, and scratching. The disease presents with eczematous, itchy lesions that show distinct distribution in different pediatric age groups, and episodes of clinical exacerbation called flares or flare-ups. AD affects 5%–20% of children, and the prevalence differs among geographical regions. The disease usually occurs in early childhood; about 85% of cases are observed during the first 5 years of life, and the disease alleviates substantially by the age of 7. In a small percentage of patients, the disease may begin in adulthood. In addition, AD may be the first manifestation of “atopic march”, which is characterized by development of asthma and allergic rhinitis at a later age.

Underlying factors that contribute to AD are impaired epithelial barrier, alterations in the lipid composition of the skin, immunological imbalance including increased Th2/Th1 ratio, proinflammatory cytokines, decreased T regulatory cells, genetic mutations, and epigenetic alterations. Atopic dermatitis is a multifactorial disease with a particularly complicated pathophysiology.
AD is diagnosed by clinical examination mainly based on morphological features and distribution of lesions; however, no laboratory or pathological findings specific to the disease have been discovered to date.
Cytokines and other chemical molecules that cause itching (pruritogens) are released from eczematous skin areas where they activate the relevant sensory nerves and cause pruritus; thus, the patient feels the need to scratch these areas. Hyperesthesia in AD is due to aberrantly elongated sensory nerves in the upper layer of the skin which are increasingly exposed to environmental factors such as dryness, irritation, and chemicals.
Fillagrin mutation is the most important predisposing genetic change in AD. However, it is found in only 10%–50% in patients with AD, and in 9% of the healthy population. Therefore, AD cannot be explained only by Fillagrin mutation. Genome?wide association studies (GWAS) have been initiated to elucidate the pathogenesis of AD.
Antiinflammatory therapy with topical calcineurin inhibitors (TCI), including tacrolimus and pimecrolimus, as well as topical corticosteroids (TCS), is reported to be the most effective approach in the treatment of acute flares.
TCSs are widely used; they are the first-line treatment for acute flares in AD. They are indicated for eczematous lesions unresponsive to daily skin care and proper usage of emollients, creams, and ointments. TCSs exhibit their effect by inhibition of T lymphocytes, thus reducing inflammation on the skin; they are also known to abate pruritus. In addition, topical corticosteroids are not only used for acute attacks but also for prevention of relapses.

✓ Fact confirmed: Childhood atopic dermatitis: current developments, treatment approaches, and future expectations P?nar GÜR ÇET?NKAYA and Ümit MURAT ?AH?NER; 2019 Aug 8.