Atopic eczema has become more prevalent in Sweden and other industrialized countries in recent decades; 15–30% of children and 2–10% of adults are affected1,2,3,4,5. More than 60% have symptoms during the first two years of life6,7, and atopic eczema is most common in early childhood years4,8. Children often recover from their atopic eczema, and about 60% of children who have had atopic eczema are symptom-free in their teens. However, many of these will recur later in life, especially with hand eczema9.
Development of atopic eczema can have many reasons, and there are undoubtedly several genes that can contribute to the disease. Still, mutations in the filaggrin gene have a robust link to eczema development. It is more common to have these mutations if you have more severe eczema, eczema that debuted early and if you also have other atopic diseases such as hay fever and asthma10. Genetics for atopic eczema, and other atopic disorders, also play an essential role. This mutation encodes proteins that are supposed to help the skin maintain its barrier function. If the barrier function is damaged, it is easier for the skin to dry out. Also, there is an inflammation in the skin that causes it to turn red and start itching. It is a combination of several of these factors that together cause atopic eczema. Eczema may also get infected with bacteria and viruses and could then need different treatment11.
The symptoms of atopic eczema are a condition with dry and itchy skin. A red rash often occurs, and there may be rashes and sometimes fluid blisters. The severity varies from person to person. Some only have small eczema areas with light itching, while others may have large skin areas with intense itching and rash. Itching and tearing further aggravate the outbreak and the skin can become inflamed and sore. An infection manifests itself as deterioration and signs that bacteria cause it may be that yellowish crusts form on the rash11.
In infants up to 1 year, the rash is usually on the face, neck, arms and legs, and trunk. Eczema can be fluid, especially on the cheeks and scalp. In children from about 3 to 11 years, it becomes drier and is often ruptured. Eczema is often symmetrically located in skin folds, face (especially around the mouth), on hands and feet, on buttocks and the back and inside of the thighs. Affected areas may have more or less pigment. In adults, the skin is generally dry and itchy and often thickened in some places as a result of itching. The rash is found in skin folds, face (especially around the eyes, forehead and around the mouth) and on the neck against shoulders and wrists/hands.
Many things can aggravate the disease: sweating due to hot clothes or physical activity. Chemicals such as detergent and soap. Dusty environments. Water, especially chlorinated water. Dry cold winter weather. Reduced humidity indoors when the house is heated. Stress. Diseases, such as colds or an eczema infection. Eczema on the lips and around the mouth is often made worse by the fact that the patient frequently licks around the mouth when it feels dry.
In many children, itching is made worse by citrus fruits, tomatoes, strawberries, chocolate and kiwi. It is not due to allergies, but because the skin is extra sensitive. It can be useful to pay attention to whether something in the food seems to make the skin worse.12 For children, food allergies can make eczema worse, which is uncommon for adults. Especially under the age of one, there is usually an allergy to cow’s milk and sometimes to eggs. If the child is allergic to cow’s milk, it usually passes before two to three years of age. Egg allergy usually disappears before school age. There may also be allergies to fish, soy, various cereals and peanuts. Infants with food allergies often have hives with eczema. Usually, the child also has respiratory symptoms and stomach upset.12
Treatment of eczema primarily consists of lubricating with plasticizers and cortisone ointments. Other drugs and light therapy may also be included in the treatment. It is good to know that it takes time to treat eczema.
Patient studies have shown that treatment with Airsonett Air4 has in many cases, led to significant improvements in eczema for asthma patients receiving treatment for their allergic asthma. Clinical studies are underway on the effect of TLA with Airsonett Air4 on atopic dermatitis, and we look forward to seeing the results. Please contact us if you have questions or want to know more.
1. https://www.lakartidningen.se/Klinik-och-vetenskap/Temaartikel/2017/11/Atopiskt-eksem-vanligt-i-alla-aldrar/ Emma K Johansson, överläkare, doktorand, hudkliniken, Södersjukhuset; enheten för dermatologi och venereologi, institutet för medicin Solna, Karolinska institutet, Stockholm
2. Bieber T. Atopic dermatitis. N Engl J Med. 2008;358(14):1483-94.
3. Åberg N, Hesselmar B, Åberg B, et al. Increase of asthma, allergic rhinitis and eczema in Swedish schoolchildren between 1979 and 1991. Clin Exp Allergy. 1995;25(9):815-9.
4. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109-22.
5. S2k guideline on diagnosis and treatment of atopic dermatitis-short version. Thomas Werfel, Annice Heratizadeh at el May 2018 Journal of the German Society of Dermatology 2016;14(1):92-105.
6. Rajka G. Natural history and clinical manifestations of atopic dermatitis. Clin Rev Allergy. 1986;4(1):3-26.
7. Bieber T. Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine. Allergy. 2012;67(12):1475-82.
8. Ballardini N, Kull I, Lind T, et al. Development and comorbidity of eczema, asthma and rhinitis to age 12: data from the BAMSE birth cohort. Allergy. 2012;67(4):537-44.
9. Williams H, Bigby M, Herxheimer A, et al. Evidence-based dermatology. 3rd Edition. Hoboken, NJ: John Wiley & Sons; 2014.9)
10. https://www.allergia.se/atopiskt-eksem-kan-bero-pa-mutationer/ Maria Bradley Allergia oktober 2019
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