Linda Moffat, RGN, SCM, Cert Health Ed.
Sister, Dermatology and Medical Procedure Unit, Cumberland Infirmary, Carlisle, CumbriaAtopic dermatitis (AD) is a common childhood condition affecting between 10 and 15% of children. Its prevalence has increased gradually over the past 30 years in developed countries and although the reason for this has not been fully investigated, there is speculation that urbanisation, air pollution, access to a wider variety of food, increase in domestic pets and higher maternal age may be contributory factors (Barneston and Rogers, 2002).
There are a number of key investigations used to determine a diagnosis of atopic dermatitis (see below). It should be noted that some of these might be distressing and impractical when dealing with babies and small children; they should therefore be carried out only when there is a clinical indication to do so. RAST or skin prick tests to inhalant allergens such as house dust mites are usually positive in atopic people but do not alter treatment, and they are unhelpful as random screening for dietary allergens, (although useful to confirm a suspect agent). Similarly, patch testing is usually unhelpful as contact allergy is rare in children.
Treating AD in pre-school children may be costing as much as £47 million a year in the UK (Dobson, 2001). AD is not necessarily a minor skin disorder; severe forms of the disease can have a major impact on a child's development and quality of life. A personal, social and financial strain may also be put on the family unit as a whole. Its effects are often underestimated and ignored by health-care professionals.
AD must include
National Eczema Society, Hill House, Highgate Hill, London N19 5NA Information line: 0870-241 3604 Website: www.eczema.org
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