Senin, 18 Oktober 2010

DERMATITIS ATOPIK, si Asma Kulit yang mengganggu..

Yang satu ini merupakan penyakit kulit anak yang terbanyak saya temui di praktek. Mulai dari yang ringan/hanya setempat hingga yang luas hampir ke seluruh tubuh sampai mengganggu kualitas hidup anak. Sayangnya banyak orang tua belum memahami betul tentang penyakit ini sehingga sering kambuh.

Jadi yuk, kita pahami bersama apa sih penyakit dermatitis atopik itu? 
Maaf nih, artikelnya masih dalam bahasa Inggris, baru saya copy-paste dari brosur informasi yang saya bagikan ke pasien di meja praktek.. belum sempat saya translate.. hehe

Eczema / Atopic Dermatitis

The terms "eczema" or "dermatitis" are used to describe certain kinds of inflamed skin conditions. A special type is called atopic dermatitis or atopic eczema.
The word "atopic" means there is a tendency for excess inflammation in the skin and linings of the nose and lungs. This often runs in families with allergies such as hay fever and asthma, sensitive skin, or a history of atopic dermatitis.
Atopic dermatitis can occur at any age but is most common in infants to young adults. The skin rash is very itchy and can be widespread, or limited to a few areas. The condition frequently improves with adolescence, but many patients are affected throughout life, although not as severely as in early childhood.
Questions & Answers
Since this condition is associated with allergies, can certain foods be the cause?

Rarely (perhaps 10%). Although some foods may provoke atopic dermatitis, especially in infants and young children with asthma, eliminating those foods is rarely a cure. You should eliminate any foods that cause immediate severe reactions.
Are environmental causes important and should they be eliminated?

Rarely. The elimination of contact or airborne substances does not bring lasting relief. Occasionally, dust and dust-catching objects like feather pillows, down comforters, kapok pillows and mattresses, cat and dog dander, carpeting, drapes, some toys, wool, and other rough fabrics, can worsen atopic dermatitis.
 

Are skin tests, like those given for hay fever or asthma, of any value in finding the causes? Sometimes, but not as a rule. A positive test means allergy only about 20% of the time. If negative, the test is good evidence against allergy.
 
What should be done to treat this condition?

See your dermatologist for advice on avoiding precipitating factors. Your dermatologist can prescribe external medications such as steroids and newer immune modifying creams. Internal medications such as antihistamines can help with the itch. Oral antibiotics may be prescribed if there is a secondary infection. For severe cases, your dermatologist may recommend ultraviolet light treatments, or other treatments.


Atopic dermatitis is a very common condition. It is not curable, but with proper treatment, the disease can be controlled in the majority of people.
Preventing Flare-Ups
1. Moisturize, moisturize, moisturize. Frequent moisturizing locks in the skin’s own moisture to prevent dryness and cracking. Apply moisturizer after bathing.
2. Limit contact with anything that irritates the skin. Soaps, bubble bath, perfumes, cosmetics, laundry detergents, household cleaners, too much time spent in water, finger paints, gasoline, turpentine, wool, a pet’s fur, juices from meats and fruits, plants, jewelry, and even lotions can irritate sensitive skin. Avoid personal-care products that contain alcohol and don’t wash hands too frequently.  


3. Avoid sweating and overheating.
4. Avoid sudden changes in temperature and humidity. A sudden rise in temperature or a drop in humidity can lead to a flare-up. 


5. Avoid scratching & keep fingernails short.
6. Dress in loose-fitting cotton clothes. Avoid synthetic fabrics, wool, and other materials that feel rough to the touch. Cotton and cotton-blend clothes usually make skin feel better.


7. Double rinse clothes, and wash new clothes before wearing. Laundry detergents can trigger flare-ups. Use a fragrance-free, neutral pH detergent and double rinsing clothes. Wash new clothes before they are worn as washing removes excess dyes and fabric finishers. Tags should be removed. 


8. Reduce stress.
Bathing and Moisturizing Guidelines
1. Avoid use hot/warm water for bathing & washing hands.
2. Avoid excessive bathing. Bathing too frequently can dry skin.
3. Use mild, non-drying pH balanced cleansers. Look for a mild cleanser that is free of fragrances, antibacterial agents, and other chemicals that can irritate the skin.


5. Avoid body sponges and washcloths. Use your hands to lather up, and never rub or scrub.


6. Pat skin partially dry with a towel. Do not rub the skin dry. Instead of rubbing the skin dry, use the towel to pat the skin partially dry and then apply moisturizer. 


7. Apply moisturizer while the skin is damp. Applying moisturizer while the skin is damp, usually within 3 minutes of bathing.
8. Select moisturizers with care. Moisturizers lock in the skin’s own moisture to prevent dryness and cracking. When selecting a moisturizer, be sure to keep in mind:
      • When humidity is low, look for moisturizers that contain 
petrolatum, mineral oil, linoleic acid, ceramides, dimethicone, or 
glycerin. 
 
      • In humid conditions, the skin can replenish itself by soaking up 
moisture from the air so a lotion may be all that is needed.
 
      • Avoid products that contain fragrances, preservatives, and other 
chemicals that can irritate the skin.
Around the Home
Indoor allergens and irritants can trigger the signs and symptoms of atopic
dermatitis.
1. Control Dust Mites. Some studies suggest that reducing dust mites can reduce symptoms; other studies show no effect. For the most part, only children have shown improvement when dust mites were controlled. This is what can be done to control dust mites in a child’s room:
           • Eliminate carpeting, rugs and blinds.
           • Limit upholstered furniture. The only upholstered item in the bedroom should be the bed.
           • Cover box spring and mattress in plastic zippered covers and wipe off covers weekly.
           • Keep furnishings to a minimum. Only items made of wood, rubber, metal, or plastic should be used. That goes for toys, too.
           • Use a pillow and mattress pad made of Dacron®.
           • Clean the room thoroughly each week. This should include wiping the floor, furniture, tops of doors, window frames, and sills with a damp cloth or oil mop.
           • Wash all bed clothes and curtains at least once a week in water that is 130° F or hotter.
           • Air the room thoroughly after cleaning.
           • Keep all animals with fur or feathers out.
2. Keep home’s humidity level between 45% and 55%. Dehumidifiers and humidifiers can keep humidity levels between 45% and 55%. Use a hygrometer, a device that measures humidity, to monitor the amount of moisture in the air. Hygrometers are available in places where thermometers are sold, such as a local hardware store. 



3. Avoid contact with pets that have fur or feathers. When fur and feathers come into contact with skin, they can cause a flare-up. Pet dander is another common trigger. Be sure to keep pets with fur or feathers out of the bedroom.



4. Avoid contact with harsh dish-washing products and household cleaners.  Look for natural alternatives to bleaches and other cleaners that contain harsh chemicals.  If you must use such cleansers, wear protective gloves.  Wearing cotton gloves under rubber gloves can help prevent a flare-up if you have an allergy to latex.



5. Cover up in the yard. If plants or other things in the yard trigger a flare-up, wearing gloves and long pants and sleeves may help prevent a flare-up.


6. Find out if any food(s) triggers the atopic dermatitis. If you suspect a food allergy is a trigger, be sure to tell your dermatologist. Tests can be run to determine which, if any, food allergies exist.


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