About Atopic Dermatitis
Atopic dermatitis (AD), commonly referred to as eczema, is a chronic inflammatory skin disease that is characterized by dry, itchy, red, swollen, and/or cracked skin.1,2
AD is one of the most common inflammatory skin diseases.3 In the US, more than 16.5 million adults and 9.6 million children have AD.4,5 Worldwide, AD affects approximately 15–30% of children and 2–10% of adults in developed countries.1
While it can occur at any age, AD most often starts in childhood, causing a rash on the face, limbs, or other body areas.1 People with AD are more likely to have other allergic conditions, like asthma, allergic rhinitis, and food allergy.6
Clinical Features of Atopic Dermatitis
Figure 1. Atopic Dermatitis
AD is a relapsing and remitting condition, meaning people can experience multiple flares per year and over the course of many years or their entire lifetime.7 It is not contagious and cannot be transmitted by touching someone who has it.
AD is typically characterized by dry, scaly skin, itching, and redness, with lesions that may ooze and form crusted patches.1,3 AD often affects the folds of the arms, back of the knees, hands, face, and neck.1,2
Itching is an especially bothersome symptom in AD, and tends to worsen at night, disturbing sleep and causing fatigue, which in children can lead to inattention at school.1,6 People with AD may also experience social and emotional distress due to the visibility and discomfort of the disease.3
Causes of Atopic Dermatitis
AD is regarded as a multifactorial disease and, while the exact cause is not fully understood, it involves both genetic and environmental factors.1
Impaired skin function and abnormal immune responses contribute to the development of AD.1 The skin in AD appears to be defective in its ability to retain moisture and function as a physical barrier.4 Without this barrier function, irritants and allergens can more easily trigger inflammatory reactions.4 Allergic (immune) responses also increase in AD, causing long-term inflammation.1
Environmental factors such as dryness, extremes of temperature, food, soaps and other irritants, allergies, and stress have all been identified as potential triggers.4
Useful Links
National Eczema AssociationDermavant is not responsible for the website content of external links.
References
- Bieber T. Atopic dermatitis. New England Journal of Medicine. 2008;358(14):1483-1494.
- Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. Journal of the American Academy of Dermatology. 2014;70(2):338-351.
- Paller AS, Kabashima K, Bieber T. Therapeutic pipeline for atopic dermatitis: End of the drought? The Journal of Allergy and Clinical Immunology. 2017;140(3):633-643.
- National Eczema Association. https://nationaleczema.org/research/eczema-facts/. Accessed November 2020.
- Sidbury R, Khorsand K. Evolving Concepts in Atopic Dermatitis. Current Allergy and Asthma Reports. 2017;17(7):42.
- Langan SM, Thomas KS, Williams HC. What is meant by a ‘flare’ in atopic dermatitis? A systematic review and proposal. Archives of Dermatology. 2006;142(9):1190-1196.
The information presented on this website is intended for educational purposes only. Readers are encouraged to consult their healthcare providers for further information.
About Psoriasis
Psoriasis is a chronic, systemic, inflammatory skin disease associated with a significant physical and psychological burden.1
Psoriasis affects approximately 8 million people in the US and 125 million people worldwide.2 Plaque psoriasis, also called psoriasis vulgaris, is the most common form and affects about 80–90% of people with psoriasis.1,3,4
The typical age of onset is 15–25 years, but psoriasis can develop at any age.2 People with psoriasis are at an increased risk of developing other chronic and serious health conditions. Comorbidities include psoriatic arthritis, inflammatory bowel disease, hypertension, diabetes, obesity, and depression.3 Psoriasis has a significant impact on quality of life and on psychological health.1,3 Nearly 60% of people with psoriasis consider the disease to be a large problem in their everyday life.5
Clinical Features of Psoriasis
Figure 1. Psoriasis plaques
Psoriasis is a chronic disease that can wax and wane, with periods of worsening and periods of milder symptoms or remission.3 It is not contagious and cannot be transmitted by touching someone who has it.1 Plaque psoriasis is characterized by raised, red patches of skin, often with silvery scales (Figure 1).1,3 Plaques can vary in size and may join into a larger area if multiple plaques are close to each other.2,3 Plaques can appear in a few areas or all over the body.1,3 Psoriatic plaques most commonly occur on the scalp, trunk, buttocks, and limbs (e.g. elbows, knees, fingernails, and toenails), affecting both sides of the body in a symmetrical distribution.1,3
Psoriasis is a chronic disease that can wax and wane, with periods of worsening and periods of milder symptoms or remission.3 It is not contagious and cannot be transmitted by touching someone who has it.1 Plaque psoriasis is characterized by raised, red patches of skin, often with silvery scales (Figure 1).1,3 Plaques can vary in size and may join into a larger area if multiple plaques are close to each other.2,3 Plaques can appear in a few areas or all over the body.1,3 Psoriatic plaques most commonly occur on the scalp, trunk, buttocks, and limbs (e.g. elbows, knees, fingernails, and toenails), affecting both sides of the body in a symmetrical distribution.1,3
Psoriasis plaques can be itchy, painful, and disfiguring, and cause significant emotional and physical distress.1,3 About 80% of patients with plaque psoriasis have mild to moderate disease, with the remaining 20% having moderate to severe disease.3,6
Causes of Psoriasis
Psoriasis is a complex autoimmune disease, meaning that the body’s immune system targets and attacks its own cells. The autoimmune disease process involves immune cells and proteins involved in the development of inflammation, such as cytokines, tumor necrosis factor (TNF)-α, interferon-γ, and interleukin (IL)-17, and leads to over-production of skin cells and inflammation.1
Psoriasis has a genetic link, as it is more common in people who have family members with the disease.1 People with a family history of psoriasis also have more severe psoriasis that starts earlier than those with no family history.1
Useful Links
American Academy of Dermatology Psoriasis Resource Center International Psoriasis CouncilDermavant is not responsible for the website content of external links.
References
- Boehncke WH, Schon MP. Psoriasis. Lancet. 2015;386(9997):983–994.
- National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/. Accessed November 2020.
- Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826–850.
- Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729–735.
- Keating GM. Apremilast: A Review in psoriasis and psoriatic arthritis. Drugs. 2017;77(4):459–472.
- Wu J, Lu M, Veverka K, et al. The journey for US psoriasis patients prescribed a topical: a retrospective database evaluation of patient progression to oral and/or biologic treatment. J Dermatolog Treat. 2019;30(5):446-453.
The information presented on this website is intended for educational purposes only. Readers are encouraged to consult their healthcare providers for further information.