How to successfully treat atopic dermatitis (Photo: Pixabay)
How to successfully treat atopic dermatitis (Photo: Pixabay)

Atopic dermatitis profoundly affects the quality of life of patients because it impacts the work, school, social, relationship and economic spheres. Precisely because it impacts many areas of the patient’s life, a multidisciplinary approach is essential.

Worldwide, it is estimated that 10% of adults and 25% of children live with atopic dermatitis and that approximately 85% of patients present the first manifestations of the disease before the age of 5 years. It is a multifactorial pathology, in which genetic and environmental factors, immunological alterations and/or problems in the skin’s barrier function intervene.

Symptoms and everyday life

The intense itching caused by dermatitis leads the patient to scratch permanently, and in many cases, to damage their skin and even predispose to infections, generating burning and pain.

Dr. María Valeria Angles, head of the Child and Adolescent Dermatology section of the Dermatology Service of the Hospital Italiano de Buenos Aires and coordinator of the atopic dermatitis working group of the Argentine Society of Dermatology explains that “The quality of life of patients, especially everything in moderate to severe cases, and that of your entire family or environment, is greatly affected. In many cases, families, couples or parents do not sleep because they have to control that the person does not scratch or hurt himself. Choosing how to dress is also a challenge for patients, who must choose clothes that do not intensify the itching”

Latopic dermatitis is not a contagious disease, however, in many children it becomes the object of ridicule, discrimination and damage to the patients’ self-esteem. “Patients frequently suffer bullying because there are still many who believe that it is a contagious disease, which indicates the great lack of knowledge about the pathology. Self-esteem is what is most affected, especially in adolescent patients. In adults, dermatitis has a great impact in the workplace since they are usually absent in cases of skin infections,” adds the specialist.

There are other diseases triggered by the same inflammatory process as atopic dermatitis, in which the patient’s immune system is overactive and generates systemic inflammatory processes. Therefore, it is very common for dermatitis to coexist with other allergic diseases, such as asthma, rhinoconjunctivitis, food allergy, among others.

“In some cases, patients start, for example, with a food allergy and then develop atopic dermatitis. In other cases, food allergy coexists and triggers exacerbations of dermatitis. At the same time, atopic dermatitis can coexist with other allergic respiratory diseases such as rhinitis and/or asthma. This does not occur in all patients, since many are not related to allergies and the disease occurs exclusively as something intrinsic to the skin,” explains Dr. Maximiliano Gómez, a specialist in Allergy and Immunology and president-elect of the Argentine Association of Allergy and Clinical Immunology.

how to treat it

This is why a multidisciplinary approach to the disease involving different professionals is essential. “The vision of the dermatologist and the allergist complement each other and the patient benefits from comprehensive care for their skin and their allergy. Working together guarantees a specialized and complementary evaluation and treatment, for the benefit of the patient”, adds Gómez.

Specialists agree on the importance of a correct and early diagnosis of the disease. “Early diagnosis favors the indication of special skin care that can prevent, in mild cases, the progression of eczema. At the same timethe correct diagnosis can contribute to relief in those cases with more serious and advanced disease” explains Dr. Marta Patricia La Forgia, specialist in Dermatology and Allergy and Immunology and adds “the certainty of the diagnosis contributes to not delaying systemic treatments avoiding thus the deterioration of the quality of life, in which mainly pruritus, influences so much”.

Advances and novelties in treatment

The Dr Gabriel Gattolin, specialist in Allergy and Immunology, former president of the AAAEIC, and coordinator of Clinical Research at the Clinical Studies Foundation and at the Rosario Children’s Respiratory Center, comments on the most important news for patients with atopic dermatitis: the appearance of biological drugs, and the approval of a JAK inhibitor that, with a daily oral dose, has been proven to markedly reduce itching and skin lesions in patients

“This is great news since these are more effective drugs, with supporting scientific studies that guarantee their safety and significantly improve their quality of life since they reduce skin lesions and itching. These new therapeutic options fill us with joy, both doctors and patients, because we can finally have something different, safe and effective to offer them. It means hope for those patients who had already tried everything that was available up to now, and did not achieve any improvement” concludes Dr. Angles.

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