Talk:Atopic dermatitis

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Removing the nonsense about psyche and emotions barring a scholarly cite beyond Sontag, who was talking about popular culture reacting to disease, and not disease reacting to popular culture.

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[edit] Please merge with "neurodermatitis"

"neurodermatitis" should definitely be subsumed by "atopic dermatitis". AFAIK the latter (or equivalently, "atopic eczema") is now the preferred term.

You are absolutely right! The leading German Handbook of dermatology [1] names the disease "Atopische Dermatitis" (German), in English this is "atopic dermatitis", and names one synonym "Neurodermitis" (German), in English this is "Neurodermatitis". -- Kind Regards, -- Paunaro 20:07, 26 September 2006 (UTC)

[edit] References

  1. ^ Fritsch P, Dermatologie und Venerologie, Springer, Berlin; 2nd edition (September 2003), ISBN: 3540003320

[edit] do not merge

1. regarding the merge with atopy: not a good idea, IMO, since atopic eczema is not the same thing as atopy, and the main eczema entry needs to be able to point to entries on each type.

2. regarding the merge with neurodermatitis: I argue against. There is some confusion on this issue, since in central Europe atopic eczema seems to be referred to -- some of the time -- as disseminated neurodermatitis. In the English speaking countries (and others?), however, neurodermatitis (or localized neurodermatitis) refers to lichen simplex chronicus and prurigo nodularis, eczemas either self-inflicted or of unknown etiology, but quite distinct from atopic dermatitis.

I think the entry on neurodermatitis should be returned to the original lichen simplex chronicus that has been overwritten with atopic stuff. V.B. 05:06, 9 October 2006 (UTC)V.B.

do not merge with atopy, they are distinct. --Coroebus 19:21, 30 October 2006 (UTC)

oh yeah, and do not merge with neurodermatitis either, as per VB atopic dermatitis and neurodermatitis are distinct (at least in the UK) --Coroebus 20:19, 15 November 2006 (UTC)
Totally agree. Atopy is an immunologic state; atopic dermatitis is a form of eczema. Do not merge.
  • Do not merge with atopy. Atopy is the systemic over-production of IgE whereas atopic dermatitis is specifically a disease of the skin. Other diseases that have a component of atopy/allergy (asthma/rhinitis/hayfever etc.) should also be dealt with separately. Atopic diseases manifest at specific anatomical sites, atopy is instead systemic and arguably not a disease in its own right.Yendor 18:39, 21 December 2006 (UTC)
  • I do not think that Atopy should be merged with Atopic Dermatitis for the reasons above. Atopic Dermatitis is a specific form of Atopy, while Atopy is a more general condition including other specific forms, such as allergic conjunctivitis, allergic rhinitis and asthma.

Dont merge with atopy because as already mentioned atopy is a immune state rather than a disease in its self. Also the current trend in research is to actually group it with other inflammatory diseases such as crohns disease and leprosy, this is because of research into the role of barrier function in these diseases. Moreover as already mentioned atopy is defined as over production of IgE, well in 20-30% of cases of AD there is no IgE overproduction.

[edit] atopisches ekzem

If you look up this entry on German Wiki, you will find that the neurodermitis term is the old one that is being superceded. However, it seems in common usage still. 170.215.67.24 05:26, 9 October 2006 (UTC)V.B.

[edit] disambiguation

I created a disambiguation page in reference to neurodermatitis, directing folks to either lichen/prurigo, or to atopic eczema. 170.215.67.24 22:53, 14 October 2006 (UTC)V.B.

[edit] not NPOV

"Although many people are intimidated by the term 'steroids,' their proper use can result in atopic dermatitis being brought under control."
This statement is not NPOV, and tends towards the irresponsible. Yes, strong steroids will superficially "cure" most skin problems. But there are also serious risks of systemic side-effects. It is important to use these drugs with care, and only use the minimum necessary, for a minimum time, to get the needed results.

"Alternative medicines may (illegally) contain very strong steroids"
Sure, they may. But most alternative medicines for eczema probably have no steroids. For example, GLA (gamma-linolenic acid) a fatty acid found in evening primrose oil, black currant oil and borage, is not a steriod. -69.87.204.151 23:48, 2 March 2007 (UTC)

  • No right-minded doctor would, I hope, not advocate anything other than using steroids "with care, and only use the minimum necessary, for a minimum time, to get the needed results", but there again is this not an appropriate approach to take with almost all medicines ? Stating that "their proper use can result in atopic dermatitis being brought under control" does not seem unbalanced - it has qualification of "proper use" and only states "control", not of any permanent cure.
  • As for alternatives... yes "most ... probably have no steroids", but there again it is probable that most don't work (for if they did and had robust evidence of this then they would be incorporated into conventional medical practice).
    • As the article cites, there have been well reported studies looking into the precise constituents of obtained supposed "pure" TCM (Traditional Chinese Medicine) preparations for eczema, that found potent steroids had been added - of course proposed regulation of herbal supply and manufacture would eliminate such events. Also (real) TCM has not been without its own reported serious systemic effects (see Perharic L, Shaw D, Leon C, De Smet P, Murray V (1995). "Possible association of liver damage with the use of Chinese herbal medicine for skin disease". Vet Hum Toxicol 37 (6): 562-6. PMID 8588298. )
    • As for GLA, why if it is so effective were the UK licenses for prescription items revoked? Answer - because became apparent initial claims for efficacy not subsequently confirmed on review & later studies. See the editorial: (13 December 2003) "Evening primrose oil for atopic dermatitis -- Time to say goodnight". BMJ 327: 1358-1359. DOI:10.1136/bmj.327.7428.1358. . Also same reasons for withdrawal in cyclical pre-menstrual breast discomfort in women. [1])
      • Kitz R, Rose M, Schönborn H, Zielen S, Böhles H (2006). "Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy". Pediatr Allergy Immunol 17 (2): 112-7. PMID 16618360.  concludes that "Dietary GLA-supplementation could not prevent AD"
    • re Borage oil, it is ineffective:
  • So, stating the conventional, evidence based treatments in favour of the ineffective alternatives is very much within NPOV guidelines. David Ruben Talk 03:15, 3 March 2007 (UTC)
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