Allergic disorders tend to run in families; having a parent with atopic dermatitis, asthma, or hay fever raises the chances a person will develop atopic dermatitis. When caused by CARD11 gene mutations, atopic dermatitis has an autosomal dominant inheritance pattern , which means one copy of the altered CARD11 gene in each cell is sufficient to cause the disorder.
Similarly, when associated with FLG gene mutations, risk of the condition follows an autosomal dominant pattern; a mutation in one copy of the FLG gene is sufficient to increase the risk of the disorder. Individuals with two altered copies of the FLG gene are more likely to develop the disorder and can have more severe signs and symptoms than individuals with a single altered copy.
When atopic dermatitis is associated with other genetic factors, the inheritance pattern is unclear.
While CARD11 gene mutations appear to cause the condition without other contributing factors, people with changes in the FLG gene or another atopic dermatitis-associated gene inherit an increased risk of this condition, not the condition itself.
Not all people with this condition have a mutation in a risk-associated gene, and not all people with a variation in a risk-associated gene will develop the disorder. Genetics Home Reference has merged with MedlinePlus. Learn more. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. Atopic dermatitis.
From Genetics Home Reference. Description Atopic dermatitis also known as atopic eczema is a disorder characterized by inflammation of the skin dermatitis. Frequency Atopic dermatitis is a common disorder that affects 10 to 20 percent of children and 5 to 10 percent of adults. Causes The genetics of atopic dermatitis are not completely understood.
Inheritance Allergic disorders tend to run in families; having a parent with atopic dermatitis, asthma, or hay fever raises the chances a person will develop atopic dermatitis.
Other Names for This Condition Atopic eczema. Research Studies from ClinicalTrials. References Bieber T. N Engl J Med. Combined immunodeficiency and atopy caused by a dominant negative mutation in caspase activation and recruitment domain family member 11 CARD J Allergy Clin Immunol. Epub Aug Filaggrin mutations associated with skin and allergic diseases. Clin Rev Allergy Immunol. Germline hypomorphic CARD11 mutations in severe atopic disease.
Nat Genet. Epub Jun Although you only need only one copy of the gene to form a normal skin barrier, two copies are important for skin barrier repair. Once the skin barrier is disrupted, moisture leaves the skin and the skin will become dry and scaly. You are more likely to get eczema if your family has a history of eczema or allergic conditions, including hay fever and asthma. In most cases, eczema is not caused or aggravated by diet. If you feel a food is to blame, see your doctor or a dietitian for proper allergy testing and dietary advice.
While eczema causes stress, and stress may increase the energy with which you scratch, stress does not in itself cause eczema. Most people with eczema find that their symptoms are made worse by common aspects of daily living, such as hot weather, frequent showering, soap, ducted central heating and overheating in bed at night. There are things you can do that may help you to better manage your eczema and reduce the frequency of flare-ups.
Always see your doctor or dermatologist for further information and advice. Skin affected by eczema is more vulnerable to a range of infections, including impetigo, cold sores and warts.
The bacterium Staphylococcus aureus may cause a secondary infection of impetigo, and possibly contribute to the symptoms of eczema. Suggestions for washing include:. People with eczema have sensitive skin. Irritants such as heat or detergents can easily trigger a bout of eczema.
Suggestions for reducing skin irritation include:. In some cases, eczema may be an allergic reaction to environmental triggers. Some people with resistant eczema may find it helpful to have allergy testing for example, prick testing for common environmental allergens such as house-dust mites, moulds and grass pollens. Abrupt temperature and humidity changes can sometimes irritate the skin — for example, going in and out of air-conditioned buildings on hot days or heated buildings on cold days.
Hard physical activity or exercise that makes you sweat heavily can also trigger the itch of eczema. Suggestions include:.
If you notice that your eczema seems to get worse after eating a particular food, you may be an exception to this. See your doctor or dietitian for proper allergy testing and dietary advice. Never self-diagnose or you risk depriving yourself of enjoyable and nutritious foods for no good reason. Unnecessarily avoiding certain foods such as dairy products can lead to nutritional deficiencies.
Emollient creams add moisture to the skin. Apply moisturisers each day to clean, dry skin. It is especially important to moisturise after showering and bathing, and when living or working in an air-conditioned or heated environment. You may need to try several different brands until you find the emollient that works best for you.
Ask your doctor, dermatologist or pharmacist for advice. Eczema responds well to anti-inflammatory creams. Topical steroids corticosteroids come in various strengths and are available by prescription from your doctor. Generally, it is better to use the lowest strength that works adequately. Using high-strength topical steroids for extended periods, especially on delicate areas like the face, can cause side effects, including thinning of the skin.
It is best to apply the cream to reddened areas after bathing, but make sure the skin is thoroughly dry. In severe cases of eczema, a short course of oral corticosteroids may be necessary. This must be done under careful medical supervision because symptoms may become worse once you have finished taking the tablets.
Pimecrolimus cream is a non-steroid anti-inflammatory cream that can help reduce flare-ups of eczema if applied at the first signs of eczema. Applying coal tar to affected areas is another way to reduce the itch from eczema. Coal tar has a strong smell and tends to stain any fabric it touches. Only use it under supervision of a doctor who is experienced in managing eczema.
Exposure to ultraviolet radiation can help reduce the symptoms of chronic eczema. A person with stubborn eczema may need up to 30 sessions. The risks of unsupervised ultraviolet radiation therapy can be the same as for sunbathing — faster ageing of the skin and greater risk of skin cancer.
Most people affected by eczema can manage the condition with creams and ointments alone. While oral medication can help people whose eczema is resistant to treatment, their side effects can include high blood pressure, increased susceptibility to all types of infections, and mood and behavioural changes.
Because of these risks, and the need for close and regular monitoring, oral anti-inflammatory treatment is only considered in severe cases of eczema that are difficult to control with other therapies. New treatments are currently being developed for moderate to severe atopic dermatitis.
One group is called biologic therapy. Dupilumab is the first of these biologic therapies to be approved by the Commonwealth Government Therapeutics Goods Administration TGA and is undergoing clinical trials in Australia and overseas for the management of severe eczema.
This treatment is generally administered by an injection into the fat tissue once a fortnight. Other biologics being investigated in clinical trials include Tralukinumab and Lebrikizumab.
Soak from the neck down or just the affected areas of skin for about 10 minutes. Do not submerge the head. Take a bleach bath no more than twice a week. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Atopic dermatitis behind the knees Open pop-up dialog box Close.
Atopic dermatitis behind the knees Atopic dermatitis can cause small, red bumps, which can be very itchy. Atopic dermatitis on the chest Open pop-up dialog box Close.
Atopic dermatitis on the chest Inflammation caused by atopic dermatitis can cover large areas of the body, such as the chest, or be limited to a few small locations. Infantile eczema Open pop-up dialog box Close.
Infantile eczema In infants, atopic dermatitis infantile eczema usually appears as red, itchy patches that are associated with very dry skin. Request an Appointment at Mayo Clinic. More Information Can baby eczema be prevented? Share on: Facebook Twitter. Show references AskMayoExpert. Atopic dermatitis adult and pediatric. Rochester, Minn.
Eichenfeld LF, et al. Guidelines of care for the management of atopic dermatitis. Section 1. Diagnosis and assessment of atopic dermatitis. Journal of the American Academy of Dermatology. Archer CB. Atopic dermatitis. In press. Accessed May 10, Eichenfield LF, et al.
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