Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
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
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.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal. Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions. Common treatment includes antibiotic ear drops.
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