A story about atopic dermatitis..

Chioma and her husband had waited 5 years to have a baby. 5 years of waiting on the Lord. 5 years of repeated tests and disappointments. All the tests showed that they had nothing that should hinder conception. They even tried IVF once that failed. You can then imagine her joy when she missed her period and her pregnancy test came out positive.

This was truly a child that they had been waiting for. On that warm afternoon in November, she had a baby girl. A girl so beautiful with cherubic cheeks, pink lips and skin so soft you’d think it was butter. They named her Adamma. She made sure she did everything for her daughter from bathing, to feeding and all the works. Exclusive breast feeding.

When Adamma was six months, she developed some itchy skin rashes around her neck, face and trunk. Itchy enough to cause her distress especially at night. Her parents were so worried. She had been using medicated soap right from birth to prevent the growth of bacteria, the nanny only carried her when her mother had finished bathing her. Visitors were always asked to wash their hands before carrying her. Infact this almost caused a fight between Chioma and her sister in law. They couldn’t understand why she had those rashes. And it seemed like as the old ones were fading away…new ones came out again weeks after.

And several suggestions came in. Nnamdi’s mum brought herbs. Chioma’s friend brought Funbact A. Their neighbour brought antiseptic solutions. Nothing seemed to work. She visited different hospitals and was given more triple action creams. Not until someone directed her to LUTH annex dermatology clinic on Harvey road in Yaba did she finally get some explanation and respite to her child’s condition.

Several questions were asked. ‘Any history of asthma in the family? History of skin issues in any of the parents growing up? What have you done to this skin since the issues started? She was wondering how these questions were related to her child’s skin issues and was already mentally rolling her eyes.

Finally…she was told her child had a condition called ATOPIC DERMATITIS and that she had been doing all the wrong things.

What is Atopic dermatitis? It is a condition that the cause is not known…however several factors play a role in its cause. The top two factors are genetic and environmental factors. So in a genetically predisposed person…(some certain genes are at work here) exposed to some environmental factors, the condition starts to manifest.

The typical presentation is itchy rashes on certain areas of the body (depending on the age group) which can become ulcerated after scratching. It can also leave behind some dark areas of skin as a sequel to repeated scratching and rubbing. 60% of patients with atopic dermatitis will present before the age of one year with the condition and almost 80% before 5 years. In other words, it is more common in childhood. However, it can happen in older children and also in adulthood. 
A family history of asthma and atopic dermatitis is a very important history as children in such families may end up with atopic dermatitis and even asthma later in life. 

It has also been noted that a lot of children are not exposed to allergens to help build their immune system adequately and this can also be a risk factor. (So all these ‘I will not allow any other person touch my child’ is not particularly helpful. Maintain hygiene at all times though)

Chioma was doing all the wrong things for her child including…

• The use of antiseptics and medicated soaps. This is not recommended for anyone’s skin as you tend to take away the normal healthy bacteria and encourage the growth of harmful ones
• The use of triple action creams: This is what is called ‘gbogbonise’ aka one size fits all. And we all know that this can never be possible. The use of triple action creams is strongly discouraged.
• Herbal concoctions in various forms.

How then do you manage atopic dermatitis? By avoiding all forms of precipitants including household dusts, mites, avoiding use of medicated soaps. Mild hypoallergenic wash instead. Avoid the use of sponge or use a soft washcloth if you must. Wear light cotton materials at all times. Stay far away from medicated soaps, antiseptics, triple action creams and herbal concoctions. And most importantly,moisturize frequently. Let the skin be slightly damp before moisturizing. Vaseline blue seal or shea butter (without any other additive in it please) are good options.

It is also important to note that there are still some unidentified triggers that you may not be able to pick out…so the condition tends to run a relapsing remitting course and is thus managed rather than treated. Most children tend to improve as they grow older. It is not uncommon for some of these children to have allergic rhinitis, repeated vernal conjunctivitis (allergic conjunctivitis without an infectious component), food allergies or asthma later in life as atopy tends to run in a ‘march’ called the atopic march with atopic dermatitis at the onset.

Adamma is doing well now and her mum is an atopic dermatitis ‘professor’ now.

As always, any relations to persons dead or alive, on facebook, Instagram, twitter or real life is simply a mere coincidence. It is just a figment of the writer’s overactive imagination.

I’ll love to hear from you but remember this blog is just to enlighten, educate and sensitize about the skin and common skin conditions and not for consultation, diagnosis or management of skin issues

All pictures from Google images