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Most popular medical Questions
Is there a genetic basis for atopic dermatitis?It is likely that both genetic and environmental factors play a role. Although specific genetic information is lacking, it has been strongly suggested that an individual's genotype determines whether he or she will develop atopic dermatitis. Many children with atopic dermatitis have a family history of atopy. If one parent has an atopic diathesis, 60% of offspring will be atopic; if two parents do, 80% of children are affected. Monozygotic twins are often concordant for atopic disease.
Are there consistent immunologic alterations in children with atopic dermatitis?
Humoral changes include elevated immunoglobulin E levels and a higher-than-normal number of positive skin tests (type I cutaneous reactions) to common environmental allergens. Cell-mediated abnormalities have been found only during acute flares of the dermatitis; these include mild to moderate depression of cell-mediated immunity, a 30-50% decrease in lymphocyte-forming E-rosettes, decreased phagocytosis of yeast cells by neutrophils, and chemotactic defects of polymorphonuclear and mononuclear cells.
What condition causes bumps on the cheeks, upper arms, and thighs?
Keratosis pilaris. Associated both with atopic dermatitis and ichthyosis vulgaris, this condition runs in families and is asymptomatic. It is characterized by spiny follicular papules, giving involved areas a "chicken skin" or "gooseflesh" feel. Usual treatment is with bland emollients or emollients that contain a mild peeling agent, such as alphahydroxy acid preparation.
What are the causes of irritant contact diaper rash?
A variety of local factors are involved. Diapers contribute to the chafing of the skin and the prevention of moisture evaporation, thus increasing epidermal hydration and permeability to irritants. Proteolytic enzymes in urine and stool and ammonia in urine irritate chafed skin. Seasoned pediatricians will advise that alcohol-based diaper wipes also feed the flames of diaper rash.
Are cloth diapers "better" than disposables?
There is no clear answer here, although there are parties who swear by one or the other. Studies, however, have shown both a decreased incidence of diaper rash with disposable diapers and a documented decrease in skin moisture and incidence of rash with superabsorbent diapers as a result of decreased leakage and less alkaline pH. The adjective "better" implies a value judgment, and other factors such as cost, environmental impact, and convenience must be considered. More than 97% of the diapers used in the United States are of the disposable variety.
Are topical steroid/antifungal preparations useful for treating children with diaper dermatitis?
Most diaper dermatitis is usually diagnosed as either irritant contact dermatitis or candidal dermatitis. Irritant diaper dermatitis responds well to very-low-potency topical corticosteroids (as a result of their anti-inflammatory properties) and a topical barrier such as zinc oxide ointment. Candidiasis of the diaper area responds well to topical antifungal preparations; rarely, an oral anticandidal medication is also necessary. In both types of diaper dermatitis, frequent diaper changes, exposure to air, and avoidance of excessive moisture are helpful. Combination preparations containing both antifungal and corticosteroid medications are not recommended to treat diaper dermatitis because the strength of the steroid component in these products is usually too high for use in the diaper area.
What are the two main types of contact dermatitis?
Irritant and allergic. Irritant contact dermatitis arises when agents such as harsh soaps, bleaches, or acids have direct toxic effects when they come into contact with the skin. Allergic contact dermatitis is a T-cell mediated inflammatory immune reaction that requires sensitization to a specific antigen.
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