Managing a Common Disorder in Children: Atopic Dermatitis
Managing a Common Disorder in Children: Atopic Dermatitis
Atopic dermatitis (AD) in children, along with asthma and allergic rhinitis, has considerably increased over the last 30 years (Halken & Host, 2000). The prevalence is approximately 10-20% of children under the age of 14 years in Western populations (ISACC, 1998; Kemp, 1999), while affecting more than 10%, at least transiently (Wahn et al., 2001). Possible reasons for this include improved awareness and ability to diagnose atopic diseases, increased environmental allergens due to "urbanization," association with affluence, or increased epidemiological reporting (Diaz-Sanchez, 2000). This non-contagious, chronic inflammatory disease is common, and thus it is important for healthcare clinicians to be familiar with the disease and its therapeutic management.
Unfortunately, AD is not often perceived as a major illness and is frequently dismissed as a minor skin condition. However, studies have demonstrated considerable financial, emotional, and social impact on families of those with moderate-severe AD (Kemp, 1999). An Australian study reported results of significantly more stress in taking care of a child with moderate-severe AD than that of a child with insulin-dependent diabetes (Su et al., 1997). Disturbed or lack of sleep has also been reported due to nighttime itching (Reid & Lewis-Jones, 1995; Wahn et al., 2001). In the U.S., AD represents some 4% of emergency room visits and the health systems of all countries are burdened with the heavy economic load of direct and indirect costs of its treatment and social morbidity (Lapidus et al., 1993).
Atopic dermatitis (AD) in children, along with asthma and allergic rhinitis, has considerably increased over the last 30 years (Halken & Host, 2000). The prevalence is approximately 10-20% of children under the age of 14 years in Western populations (ISACC, 1998; Kemp, 1999), while affecting more than 10%, at least transiently (Wahn et al., 2001). Possible reasons for this include improved awareness and ability to diagnose atopic diseases, increased environmental allergens due to "urbanization," association with affluence, or increased epidemiological reporting (Diaz-Sanchez, 2000). This non-contagious, chronic inflammatory disease is common, and thus it is important for healthcare clinicians to be familiar with the disease and its therapeutic management.
Unfortunately, AD is not often perceived as a major illness and is frequently dismissed as a minor skin condition. However, studies have demonstrated considerable financial, emotional, and social impact on families of those with moderate-severe AD (Kemp, 1999). An Australian study reported results of significantly more stress in taking care of a child with moderate-severe AD than that of a child with insulin-dependent diabetes (Su et al., 1997). Disturbed or lack of sleep has also been reported due to nighttime itching (Reid & Lewis-Jones, 1995; Wahn et al., 2001). In the U.S., AD represents some 4% of emergency room visits and the health systems of all countries are burdened with the heavy economic load of direct and indirect costs of its treatment and social morbidity (Lapidus et al., 1993).
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