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The Itch that Rashes!

Many rashes are itchy, but itchy skin that rashes is typical of Atopic Dermatitis commonly referred to as allergic eczema.

The skin is very itchy and the urge to scratch is unbearable.  With scratching, the skin becomes dry, red, cracked and sometimes bleeds and oozes.  If oozing occurs, this could indicate a secondary superficial bacterial infection.   The skin of persons with eczema is more likely to be colonized with Staph bacteria and prone to infection with Staph.

The location of the rash is helpful to distinguish atopic dermatitis from other types of eczema and other rashes.  The distribution or location depends on the age of the person.   Infants tend to have the rash over the cheeks and lateral surfaces of the arms and legs, sparing the scalp and diaper area.  Older children and teens tend to have the flexural surfaces affected meaning the inside of the elbows, behind the knees and the face.  Adults can have the rash on the neck.   The ear lobes are commonly affected.  Nipple eczema is fairly specific for atopic dermatitis.

Atopic dermatitis usually starts during infancy or childhood, but many affected individuals will continue to have flares of atopic dermatitis well into adulthood.  About 65% of patients will develop symptoms before age 1 and 90% of patients before age 5.

Common triggers of Atopic dermatitis:

  • Extreme temperatures and sweat • Abrasive materials
  • Fragrance (cosmetics, shampoos, soaps, laundry detergent, fabric softeners)
  • Wool and synthetic fabrics like nylon • Dyed fabrics
  • Allergy (foods, dust mite, pet dander, pollen) in about 1/3 of those with moderate to severe skin disease
  • Saliva (from drooling) and prolonged exposure to water

Atopic Dermatitis can be frustrating to parents and patients as it waxes and wanes sometimes without an obvious trigger.   Your allergist can diagnose various skin rashes including atopic dermatitis and develop a plan to identify the triggers, heal the skin and relieve that itching!

For more information on atopic dermatitis and other forms of eczema visit http://www.nationaleczema.org/living-with-eczema/eczema-quick-fact-sheet

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