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36 Sanford Street
Fairfield, CT
203-254-0179

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Trumbull, CT
203-459-8712

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Atopic Dermatitis (AD) is a chronic, itchy, inflammatory condition of the skin in people with environmental or food allergies. It usually occurs in childhood, but occasionally persists into adulthood. In adults, it most commonly affects the folds of the elbows and behind the knees. At times it involves the eyelids but can be generalized to almost any area of skin. Rarely, it is associated with eczema around the nipples. Because breast cancer can also cause nipple eczema, this must be excluded, especially if only one breast is involved. In children, atopic eczema can be very extensive, affecting almost the entire skin. More commonly, involvement in children is less severe and affects the cheeks, knees and elbows. AD is also associated with a skin disorder known as keratosis pilaris. It is usually found on the outer surface of the upper arms and looks like "chicken skin". It is caused by abnormal shedding of sloughed skin, which then plugs hair follicles. Long standing AD is also associated with cataracts, and a cone shaped deformity of the clear part of the eye (cornea) known as keratoconus.Atopic Dermatitis Infant The exact role of allergy in the cause of atopic dermatitis is debated. Almost all children with atopic dermatitis have food allergies. Infant formula most be adjusted accordingly and mothers who are breast feeding need to eliminate these foods from their diet. New evidence indicates that a defect in the barrier properties of the skin caused by a mutated or absent skin protein (fillagrin) may be the primary cause of atopic dermatitis and the allergen sensitization occurs secondarily increased permeability of the skin to allergens. Mutations in fillagrin have been found in almost half of an Irish population studied. Acquired deficiencies of fillagrin have been demonstrated in vitro by a research group in Denver Colorado. Treatment of AD requires identification of allergic triggers, topical steroids, non-steroid anti-inflammatory creams and antibiotics. The most common environmental allergen associated with atopic dermatitis is dust mite, and the most common foods are eggs, milk, wheat, soy and peanut. Most children with atopic dermatitis have a least one parent with allergies. In the first year of life, food allergies are quite commonly linked to atopic dermatitis. Atopic dermatitis has a similar appearance to allergic contact dermatitis and irritant dermatitis, and usually can only distinguished by it location. Allergic contact dermatitis is a rash caused by substances in contact with the skin. When there are atypical features of the rash such as its location or persistence, allergy to the steroid creams used to treat the rash should be excluded by performing a patch test. Atopic dermatitis usually precedes the development of nasal allergies, asthma and ocular allergies in young children. New drugsthat have just been released for AD include Crisaborole and Dupilumab.