Atopic Dermatitis (cont.)
Can atopic dermatitis affect the face?
Yes. Atopic dermatitis may affect the skin around the eyes, the eyelids, the eyebrows, and lashes.
Scratching and rubbing the eye area can cause the skin to change in
appearance. Some people with atopic dermatitis develop an extra fold of skin
under their eyes, called an atopic pleat or Dennie-Morgan fold. Other
people may have hyperpigmented eyelids, meaning that the skin on their eyelids
darkens from the inflammation or hay fever (allergic shiners). Patchy
eyebrows and eyelashes may also result from scratching or rubbing.
The face is very commonly affected in babies who may drool excessively and become irritated from skin contact with their flowing saliva.
Is the sufferer's skin type important?
Yes. Differences in the skin of people with atopic dermatitis may contribute to the symptoms
of the disease. The epidermis, which is the outermost layer of
skin, is divided into two parts: the inner part, which contains moist,
living cells, and the outer part, which consists of dry, flattened, dead cells. Under normal conditions, the outer layer
of skin acts as a barrier, keeping the rest of the skin from drying out and
protecting other layers of skin from damage caused by irritants and
infections. When this barrier is damaged or is naturally thin, irritants act
more intensely on the skin.
The skin of a person with atopic dermatitis loses too much moisture from the epidermal layer. This allows
the skin to become very dry, which reduces its protective abilities. In
addition, the skin is very susceptible to recurring disorders, such as
staphylococcal and streptococcal bacterial skin infections,
warts, herpes simplex, and molluscum contagiosum
(which is caused by a virus).
Skin features of atopic dermatitis
- Lichenification: thick, leathery skin resulting from constant scratching and rubbing
- Lichen simplex: refers to a thickened patch of raised skin that results from repeat rubbing and
scratching of the same skin area
- Papules: small, raised bumps that may open when scratched, becoming crusty and infected
- Ichthyosis: dry, rectangular scales on the skin, commonly on the lower legs and shins
- Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs. These are also described as gooseflesh or chicken skin and may have a small coiled hair under each bump.
- Hyper linear palms: increased number of skin creases on the palms
- Urticaria: hives (red, raised bumps), often after exposure to an allergen, at the beginning
of flares, or after exercise or a hot bath
- Cheilitis: inflammation of the skin on and around the lips
- Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
- Dark circles under the eyes: may result from allergies and atopy
- Hyperpigmented eyelids: eyelids that have become darker in color from inflammation or hay
fever
- Prurigo nodules also called "picker's warts" are not really warts at all. These are small thickened bumps of skin caused by repeated picking of the same skin site.
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Next: What are the stages of atopic dermatitis? »
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