As the weather turns colder in winter, there are often long queues at dermatology clinics. Ms. Li (pseudonym) is one of them who is deeply troubled by atopic dermatitis. She usually doesn’t even have colds and fevers. This winter, she began to have an itchy “rash” on her body, and her skin condition became worse and worse. , it turned out to be atopic dermatitis again. The recurring itching caused her to have trouble sleeping and become depressed, which began to affect her daily work, making this New Year “not peaceful”.
In this regard, Associate Professor Zhao Zuotao from the Department of Dermatology, Peking University First Hospital reminded: “Atopic dermatitis has four major characteristics: chronic, inflammatory, itchy and recurrent. In winter, the weather is cold and dry, the temperature reaches record lows, and external environmental stimulation can easily cause Patients with atopic dermatitis are experiencing exacerbations and relapses and urgently need long-term, standardized disease management and daily skin care.”
Dermatology’s “number one disease”
Atopic dermatitis is regarded as the “number one disease” in dermatology. It is a type 2 inflammatory disease characterized by dryness, itching and the recurrence of chronic eczematous skin lesions. In the past, it was often simply diagnosed as “eczema”. In recent years, the incidence of atopic dermatitis has been increasing. The incidence rate is 5-10% in adults and 10-15% in children. This disease cannot be ignored.
Loss of moisture and impaired skin barrier function
In winter, atopic dermatitis is more likely to worsen and relapse. This is because the moisture content of human skin is less than that of ordinary people. The dry air and low humidity in winter may aggravate the lack of moisture and even accelerate the dispersion of moisture in the skin into the air, causing Impaired skin barrier function. Coupled with factors such as insufficient body care and inadequate moisturizing, it is easy for atopic dermatitis to “come back”.
The underlying pathogenesis is “inflammation”
“The most obvious daily experience of patients with atopic dermatitis is ‘itch’, unbearable itching. But ‘itch’ is just a symptom. The deeper pathogenesis is ‘inflammation’, which is medically called type 2 inflammation. Among them, two The cytokines interleukin 4 (IL-4) and interleukin 13 (IL-13) play a key role and are important ‘switches’ in inducing inflammatory responses. Therefore, finding the root cause of the disease is critical for treatment.” Zhao Zuotao explained, ” If it cannot be effectively controlled, the disease can easily relapse. Patients may suffer from severe itching, skin lesions, sleep disruption and other disease burdens. Their normal work and study rhythms will be interrupted, and social situations will be limited, seriously affecting their physical and mental health and life. quality.”
High risk of allergic rhinitis, asthma, etc. in the future
Atopic dermatitis is only the “first stop” for type 2 inflammation-driven diseases. If you suffer from atopic dermatitis in the early stage, the risk of comorbidities with other type 2 inflammatory diseases such as allergic rhinitis and asthma will be higher in the future. Zhao Zuotao added: “Therefore, the control of atopic dermatitis is particularly important for teenagers, infants and young children. It not only requires long-term treatment, but also requires timely treatment. Be wary of ‘one disease causes many diseases’ to avoid causing problems at critical moments of growth, development, learning, and psychological growth. A greater burden.”
Patients have misunderstandings about the disease
In the process of frequent relapses of atopic dermatitis, there are environmental “external factors” and patients’ “own factors”. Currently, many patients still have misunderstandings about the disease, and have weak awareness of standardized treatment and long-term disease management, and are prone to fall into “diagnosis- In the cycle of “treatment-discontinuation-relapse-retreatment”, if things go on like this, patients will easily lose confidence in treatment, which will lead to recurrence and aggravation of the disease, affecting the quality of life.
For example, some patients mistakenly believe that atopic dermatitis is just an allergy, and as long as they are not allergic, they are done; or they mistakenly believe that the disease is caused by low immunity and lack of effective skin cleaning, and they think it is a non-fatal minor problem and “treat it casually” “It will be fine”; or they are eager to treat the disease, hoping to quickly relieve dermatitis and itching and completely cure the disease, so they frequently change treatment plans or stop the medication at will once it is effective, resulting in poor treatment effects.
Patients should be mentally prepared for “long-term battle”, with ‘years’ as the unit
In this regard, Zhao Zuotao emphasized, “Atopic dermatitis, as a chronic disease, requires long-term standardized management like diabetes and hypertension. After having a treatment method that suits them, patients need to be mentally prepared for a ‘long-term battle’ , establish long-term treatment goals based on ‘years’. Such stable long-term control can not only resist the risk of frequent relapse to a certain extent, but also help long-term important life stages such as growth, study, and career not to be interrupted by relapse.”
Long-term treatment considers efficacy and side effects
When choosing a treatment plan, patients with atopic dermatitis can choose a suitable plan according to the severity of the disease according to the doctor’s advice. The treatment of atopic dermatitis includes basic treatment, topical drug treatment, physical therapy, systemic drug treatment, etc. In long-term treatment, efficacy and side effects are often considered, hoping to better control symptoms, reduce and prevent recurrence.
Zhao Zuotao said, “Patients with mild to moderate symptoms can be treated with topical drugs and oral antihistamines on the premise of basic treatment; patients with moderate to severe symptoms can choose systemic treatments, such as some innovative therapies represented by biological agents that can accurately target The signaling of IL-4 and IL-13, the key pathogenic factors in type 2 inflammatory response, can control type 2 inflammation for a long time and achieve ’cause-based treatment’.”
Some patients have high awareness and cooperation of standardized disease management, and their condition has improved significantly after persisting in standardized treatment for a period of time.
Limit shower or bath time to 5-10 minutes
After entering winter, patients with atopic dermatitis especially need to pay attention to daily skin care to avoid dry skin and be wary of aggravation of the condition. Zhao Zuotao suggested:
In terms of clothing, patients with atopic dermatitis should try to wear pure cotton, loose and breathable clothing, and avoid irritating detergents when doing laundry;
In terms of diet, you must not blindly avoid foods. Food avoidance should be based on reasonable allergen examination and medical history;
In terms of washing and care, the duration of showering or bathing can be controlled within 5-10 minutes, the water temperature should not be too high, and moisturizing lotion should be applied in time to protect the skin barrier;
In terms of accommodation, keep indoor air fresh, open windows regularly for ventilation, and pay attention to maintaining appropriate indoor temperature and humidity, especially in dry winter.