Atopic Dermatitis Atopic Dermatitis

Atopic dermatitis is allergic skin. It is characterized by redness, itching, weeping or scaling. The skin has complex immune functions, and in atopic dermatitis, certain branches of the immune response are overactive - allowing histamine and other inflammatory substances to be released. A tendency for atopic dermatitis can be inherited, along with a tendency towards asthma and allergies.

Food and air borne allergens play a role. The most common food allergens are cow's milk proteins (such as the lactoglobulins in whey, casein ), egg white (albumin) and peanut butter. Wheat, soy, apple juice, and corn are some of the other common foods that aggravate some people. Of special note--cow's milk, eggs and peanut butter lead the list of allergens found in school-aged children. In young infants, green peas and apple juice are sometimes found to cause eczema.

The exact mechanisms by which foods influence eczema are not fully understood. The skin is a very active immune organ and is in constant communication with the rest of the body through the blood stream. Children often have a post viral rash after several days of fever. This is due to more T cell traffic under the skin after the illness. A similar phenomena occurs with food allergens. It is thought that the presence of the offending food causes more immune cells under the skin, and this can cause a low grade release of histamine from specialized skin cells. In young babies, eczema can take several months to present itself. In fact, babies who are sensitive to cow's milk proteins often come down with the characteristic patches at about 3-4 months of age, even though they've been on the same formula since birth.

Parents of children with eczema have to play detective to try to distinguish what food might be irritating...cow's milk formula? Cheese? Apple juice? Peanut butter? It's a good idea to take away one food group at a time, for about a month to see if any improvement occurs. More importantly, it's good to avoid lots of artificial flavors and colors, such as those found in fruit "drinks" and 10% juice "juice boxes." Kids with eczema are better off drinking whole fruit juices, diluted with water. Juices are a very concentrated form of fruit and if one is mildly allergic to sometime like cranberries, cranberry juice is taking a lot of cranberries in one gulp.

The maintain of treatment is trying to identify and minimize exposure to allergens, and moisturizing the skin. Emollients form a microscopic barrier that helps protect the skin against allergens. (See the article on Eczema).