Atopic dermatitis is a chronic skin inflammation state, and recurrent, accompanied by itching, which is associated with atopy. The word “atopy” was first introduced by Coca (1928), which is the term used for a group of diseases in individuals who have a history of sensitivity in the family, for example: bronchial asthma, allergic rhinitis, allergic conjunctivitis and atopic dermatitis.
- Genetic factors, there is a history of atopy stigmata such as bronchial asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis and in the family.
- Immunologic factors, in patients found an increase in the amount of IgE in serum.
- Psychological factors, such as emotional stress can aggravate atopic dermatitis.
- Precipitating factors that can aggravate atopic dermatitis (food, inhalants, and other allergens, low humidity, excessive perspiration, use of irritation).
Signs and Symptoms
The main symptoms of atopic dermatitis is itching (pruritus). Will occur due to scratching skin disorders vary, for example, papules, lichenification and ekzematosa lesions, such as; erythema, papulo-vesicles, erosion, excoriation, and crusting. Atopic dermatitis may occur in infancy (infantile), children, and adolescents and adults.
- In children with atopic dermatitis, 75% will be accompanied by other allergic diseases later in life. Patients with atopic dermatitis have a tendency to easily get viruses or bacterial infections (impetigo, folliculitis, abscesses, vaccinia. Molluscum contagiosum and herpes).
- Viral infections are generally caused by herpes simplex or vaccinia and called: eczema herpeticum or eczema vaccinatum. Eczema vaccinatum is already rare, usually occurring on the varicella vaccine, both the family and the patient. Herpes simplex infections caused by contracting by a family member. Vesicles occur in the area of dermatitis, easily rupture and form crusts, then it has spread to areas of normal skin.
- Patients with atopic dermatitis, have tended to increase in the number of colonies of Staphylococcus aureus.
Hanifin and LOBITZ (1977) define the criteria for the diagnosis of atopic dermatitis in detail as follows:
There must be:
- Typical morphology and distribution: flexural lichenification in adults, picture of dermatitis on the cheeks and extensor in infants.
- Tendency to become chronic or recur.
Plus 2 or more other signs:
- The presence of atopic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis) in patients or their family members.
- Rapid test reactive skin types.
- Dermographism white or raised in pallor tests with cholinergic agents.
- Anterior subcapsular cataracts.
Plus 4 or more of the following items:
- Xerosis / ichthyosis / hiperlinear palmar.
- Pityriasis alba.
- Keratosis pilaris.
- Facial pallor / dark color infra-orbital.
- Signs “dennie morgan”.
- Increased levels of IgE.
- The tendency to get in the hands of non-specific dermatitis.
- The tendency of recurrent skin infections.
Nursing Diagnosis for Atopic Dermatitis
1. Impaired skin integrity related to the dryness of the skin.
2. Acute pain related to pruritus.