The skin disease, which manifests itself as redness and itching, also causes significant repercussions on the quality of life and social relationships in younger people. A strong alliance between the parents and the dermatologist is necessary in these cases
They feel depressed and end up eating too much or too little, engaging in substance abuse, or self-harm. The impact of atopic dermatitis on children and adolescents can be much more serious than until recently estimated and can drug addiction, alcoholism, anorexia, bulimia, obesity. Big problems with one common denominator: the difficulty in building healthy relationships with others. A large US survey published in the scientific journal paints the gloomy picture of minors suffering from this inflammatory skin disease Jama Dermatology
concerning almost 12 thousand children who showed the first symptoms starting from six months of life or during childhood and adolescence.
In Italy, one in 10 adults and one in four children suffer from it
Researchers at the University of California monitored the psychological well-being of the very young patients, all followed on average for ten years, through specific questionnaires and found that between 10 and 22% of them suffer from the so-called internalizing behaviors, directing the troubled energy of emotional distress towards oneself and self-harming oneself due to low self-esteem. Atopic dermatitis manifests itself with skin dryness, redness and itching, often intense and sometimes uncontrollable, so much so as to cause serious sleep disturbances and therefore difficulty in performing school or work activities adequately – he explains Ketty Peris, president of the Italian society of dermatology SIDeMaST and director of the dermatological clinic at the Catholic University of the Sacred Heart Policlinico Gemelli in Rome -. It also affects about one in 10 adults and one in four children in Italy. Especially in moderate and severe forms, the discomfort for patients, adults or children, can be of a significant extent, so much so that compromise their quality of life. And the data from the American study clearly highlights that internalizing behaviors they appear as early as 4 years of age, even in children with non-severe forms of atopic dermatitis.
It often improves with adolescence
The most frequent causes of the pathology are a genetic predisposition hypersensitivity to allergens present in the surrounding environment (in fact about 30% of patients sooner or later also presents asthma and allergic rhino-conjunctivitis) and alterations of the skin barrier. In small patients, then, due to a compromised and less efficient skin barrier, they are often observed infections. a chronic inflammatory disease – adds Luca Stingeni, director of Dermatology and of the School of Specialization in Dermatology and Venereology at the University of Perugia and SIDeMaST councilor -: generally begins in childhood (even a few months old) and in most cases it improves around the age of 10-12. But it can also begin in adults, rarely in the elderly. Once it appears it can last for months, more often years, with phases of improvement alternating with worsening. If today still there is no definitive cure that allow us to talk about healing, in order to act on several fronts to limit the ailments.
The therapies
It is necessary to evaluate the intensity of the itch, the extent and location of the lesions, the clinical course and the impact of the disease on the patient – underlines Peris -. In most cases, standard therapy is based on the application of corticosteroids and topical calcineurin inhibitors on affected areas to reduce inflammation and itching. If the affected area is vast, there are traditional systemic therapies (ie drugs by mouth) such as cyclosporine and, for moderate or severe cases, also the new biological therapies (such as dupilumab or tralokinumab) or so-called “small molecules” (such as Jak inhibitors, such as upadacitinib) tested and approved in Europe in adolescents over 12 years of age. In children from 0 to 12 years of age, the new biological drugs are not yet reimbursed. The ultimate goal make the lesions on the skin and itching disappear, achieving long-term stabilization and reducing the severity and duration of exacerbation episodes. To be successful, it is essential that children adhere with precision and consistency to the prescribed treatments – concludes Stingeni -. We need a constant relationship between dermatologist, parents and young patients to choose the most suitable therapy for each individual case and, when necessary, reshape it over time. Alongside drug therapies, it is then essential that you counteract dry skin by using it regularly emollient and moisturizing products aimed at improving the state of the skin barrier.
December 10, 2021 (change December 10, 2021 | 18:43)
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