Allergic dermatitis and atopic dermatitis: what to do in the spring

Not just flowers. In spring, allergies also bloom. Often those who manifest the classic respiratory symptoms related to pollen (but also to other allergens) can develop a concomitant skin sensitivity: «This occurs in 35 percent of cases, when patients complain of one allergic dermatitis triggered by contact with certain substances or due to the resurgence of a chronic disease such as atopic dermatitis “, explains the professor Gabriella Fabbrocini, director of the UOC Clinical Dermatology of the University of Naples Federico II. “The latter, although not having an allergic basis, is linked to a particular sensitivity of the immune system, so that in the change of seasons it can resurface and return to manifest itself”.

How allergic dermatitis manifests itself

It’s not a casuality if we often talk about “Allergic march”, an expression with which the path taken by children subject to allergies is described, who leave one behind to immediately suffer from a new form: “Infants with atopic dermatitis will more easily develop asthma and allergic rhinitis as adults, because they can acquire different susceptibilities, first on the skin and then on the respiratory level “, says the expert. In this mix of origins, atopic dermatitis is recognized by some characteristic signs: in the first months of life can take the classic shape of the cradle capthat is, scabs that generally appear on the baby’s head, but can sometimes also affect the cheeks or the area of ​​the thighs and abdomen.

«With the passage of time, the dermatitis moves, becomes more discreet and appears for example only in the hollow behind the knees, in the inner crease of the elbows or on the neck, especially during heavy sweating and sporting activities. In most cases, these itchy rashes stop their course within the first 8-10 years of age; at other times, however, they can persist or recur during puberty, under the hormonal push, when atopic dermatitis occurs mainly around the eyes and mouth, behind the neck, on the hands, behind the knees and in the inner fold of the elbows ” .

The same is true in adulthood, when dermatitis also determines a social desease, like all visible diseases that can trigger other people’s questions, looks or prejudices. “When it comes to” pure “allergic dermatitis, therefore without the atopic component, skin rashes and itching appear above all in areas that come into contact with a certain allergen, such as on the hands or face if the culprit is the nickel present in the soap for example “.

How to distinguish allergic dermatitis from stress

But is it always allergy or can it be stress? “In prenatal development, the skin and the nervous system derive from the same embryonic sheet, the ectoderm: in other words, they arise from the same tissue and remain connected throughout life, exchanging continuous information through special physiological messengers, the neuropeptides, proteins that they allow emotions to influence the skin, especially when they are intense and recurrent ». For this reason, some manifestations affecting the skin may not represent the result of skin pathologies or affecting internal organs or perhaps due to alterations in metabolism or hormonal imbalances, but constitute a sort of “Secret message” of the body, which brings out its discomforts. “So, there is indeed a form of stress-related dermatitis, but here too there is a correlation with the atopic one, so you have to be predisposed. Basically, more than a stress dermatitis, it is a latent dermatitis that stressful events can awaken “.

How is the diagnosis made

If suspected, allergic dermatitis can be diagnosed with the patch testwhich is performed by applying on the patient’s back some patches containing the substances to be tested: after 48-72 hours they are removed and any allergic response occurs, which manifests itself with redness, itching, or blisters.

«They don’t have much use instead i traditional blood tests used for respiratory allergies, including those for the dosage of specific IgE, which are not very indicative for the skin “, explains Dr. Fabbrocini. “Rather anamnesis is importantbecause the patient’s history can provide valuable information to the specialist to define the picture ».

How it is treated and how it is kept under control

Allergic dermatitis and the atopic “sister” they cannot be solved with natural or do-it-yourself remedies, but the intervention of the dermatologist is always necessary. «Especially in the acute phase, gods can be used corticosteroids topicals or systemicantihistamines or topical calcineurin inhibitors, very innovative medicines, such as dupilumab, which can stop the atopic form.

But they are new solutions are coming, which will make a difference in the treatment of these pathologies ”, announces the expert. Logically, once the acute phase is over, it is then up to the patient to keep the situation under control, avoiding anything that can inflame the skin: substances that are too aggressive, foaming soaps, products containing nickel, low quality cosmetics and clothing, furniture that is excessively rich in carpets, curtains or plush.

When he goes away”

With the right therapy, atopic dermatitis can regress within a month and a half, while in allergic dermatitis the behavior of the patient is fundamental, who must follow the prevention measures provided by the dermatologist to no longer come into contact with the allergen. .

What foods are indicated

Often, those who suffer from allergic or atopic dermatitis are afraid of sitting down at the table: “In reality, there is no great evidence in this area or at least it is not easy to identify the cause-effect relationship. Certainly, in a subject with easily flammable skin, all those foods that release histamine, such as dairy products, tomatoes, aubergines or chocolate, can worsen the manifestations. But just like stress, it is not nutrition that triggers the problem; at most, can aggravate it. In any case, it is useless to remove food without a real medical indication: we would only risk falling into food shortages, perhaps without any benefit on dermatitis », Dr. Fabbrocini observes.

What is the best cream

Especially in the preventive phase, it is good habit to constantly moisturize the skin with soothing and nourishing creams that help keep its defensive barrier intact and efficient. The most effective active ingredients are hyaluronic acid, ceramides, nicotinamide, natural oils and other substances that have the ability to retain water in the tissues, raising a “fence” against the outside world.

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