Dermatoallergy - Kolan British Hospital


Atopic dermatitis; Is a type of allergy that involves multiple systems. It may be seen in the respiratory system, skin, eyes, and/or gastrointestinal system, and leads to complaints such as eczema and urticaria (hives) reactions on the skin, sneeze, nasal discharge, shortness of breath and asthma in the respiratory system, itching, swelling and reddening in the eyes, and nausea and diarrhea in the gastrointestinal tract. In babies, it begins with redness on the cheeks. In such babies, reactions such as rash and cradle cap are frequently seen.

Atopic dermatitis starts after 2nd month, and may continue for a lifetime or disappear at a transition phase. This transition phase may be the transition from babyhood to childhood, from childhood to adolescence, or from adolescence to adulthood.

Both genetic and environmental factors take part in this condition. If mother, father or both parents have atopic dermatitis, child likely has atopic dermatitis too. Environmental factors are called allergens. The substances causing allergy, the allergens, are detected with allergy skin and blood tests.

Skin allergy tests are prick test and patch test. Prick test is carried out by making very small holes on the skin of forearm, and dropping allergens thereinto. In the state-of-art systems, a single applicator with five pins is used for both pricking and dropping operations, and thus, these operations are done in a single application. After ten minutes, the allergen administration sites exhibiting redness, swelling or even water blisters are, if any, detected. Reaction intensities are classified as +, ++, +++ and ++++. Positive results are most frequently seen for pollens and house dust mites. Vaccines have been developed for allergens giving positive results in the tests. These vaccines are administered not only as injections via needles, but also as sublingual drops.

Patch test is performed by attaching paper patches impregnated with allergens to the back skin. After two days, the attached papers are peeled off, and the presence of redness, swelling or even water blisters on the allergen administration sites is visually checked. Reaction intensities are classified as +, ++, +++ and ++++. Positive results are most frequently seen for substances such as metals and rubber, as well as for cosmetic and skin creams, shampoos and dyes.

Good results are achieved by avoiding substances with positive test results, familiarizing the body with such allergens to increase tolerance thereto, and/or using ketotifen, in addition to vaccine treatment, to inhibit activity of mast cells having a main role in allergy and to balance such cells. Moreover, the skin of patients with atopic dermatitis is dry and itchy. Evening primrose oil can be given as an adjuvant therapy in order to eliminate dryness and normalize the unsaturated fatty acid balance.  

For the skin sites with eczema, pimecrolimus, tacrolimus and cortisone creams can be administered.