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General Category => Skin Complaints and Skin Disorders => Eczema Board => Topic started by: Aya on Thursday April 17, 2008, 04:27:11 AM

Title: New Member
Post by: Aya on Thursday April 17, 2008, 04:27:11 AM
  My wife has Atopic Dermatitis and she has had it all her life 33 years...  She is Japanese national.  I am in the Navy and the funny thing is you should see and hear what these navy doctors do the first time they heard of it...  Anyways she has it on the bottom of her feet and she is up most of the night scratching till she bleeds sometimes.  She is prescribed Pro Topic and uses it once a day.  Just wondering what else it out there to help the itch?  She has tried every cream in the book I think.  I am transfering back to Japan in June can't wait cause I know she was seeing a good Japanese doctor over there. I just wish they would find a cure for this crap.  We have two boys my youngest gets a few spots now and then but they go away pretty quick.  As for me I don't have that stuff at all.  I feel so sorry for her, 11 years of marriage and still trying to find something to help her. Bobby
Title: Re: New Member
Post by: bunnie on Thursday April 17, 2008, 12:26:06 PM
Hi Bobby , welcome to skincell. The following I have copied from my blog. This is what Atopic Dermatitis is.
There is no cure Bobby because your wife was born with mutated genes predisposing her to having an abnormal immune response to exogenous pathogens which normally are harmless. That is things like dust, pollen or anything that is outside of the body which your wife may be allergic to. The problem is finding out which of these factors are at the cause. Atopy tends to run in families. here is my blog on that...
Atopy is an inherited predisposition which causes a tendency to suffer from one or more of the following “atopic diseases”: allergic asthma, allergic rhino-conjunctivitis, and atopic dermatitis. The diagnosis of “atopy” is not based on one single distinctive clinical feature or laboratory test, but rather results from a combination of patient and family history and clinical findings. These features include:
1)Family and patient history with regard to eczema, allergic rhinitis and allergic asthma
2)Patient history with regard to milk crust, sweat-induced pruritus, intolerance of certain cloth fabrics or metals, and photophobia.
3)Present or past clinical findings such as xerosis cutis, ear fissures/ eczema, dyshidrosis or dyshidrotic hand eczema,pityriasis alba, atopic winter feet, nipple eczema, angular cheilitis.
4)Atopic stigmata such as palmer hyperlinearity, Hertoghe's sign, keratosis pilaris. 5)White dermographism, and acrocyanosis. As mentioned above, atopy may lead to the eczematous disease “atopic dermatitis”. It may also facilitate the development of irritant contact dermatitis.

Genetics of atopic dermatitis:
The risk for AD is doubled in children whose father or mother have a history of atopy and it is more than 50% if both parents have at least one atopic disease. Interestingly AD is rather associated with maternal than paternal atopy. Several genes are suspected to be linked to AD such as 5q31-33 with a cluster of cytokine genes.

Immunology of atopic dermatitis:
The best founded explanation for the increase of AD is the so called “hygiene hypothesis”, which assumes that atopic diseases are prevented by infections in early childhood contracted e.g. through contact with other siblings or playing outside. This theory is supported by the already known potential risk factors for AD like small family size, increased income and use of antibiotics or migration to urban environments. Immunological findings also sustain the “hygiene hypothesis“.
Allergic responses are pushed by the T helper-cell type (TH)2 immune response. On the other hand infections are induced by TH 1 immune responses. TH 1 responses antagonise the development of TH 2 cells. This could be the explanation why a decreased number of infections during early childhood could boost the TH 2 allergic responses. Read th1 and Th2 in the link. (this is where understanding the Immune system comes in useful!) If you don't understand it, please ask, or read my blog on the link at the end.

Triggering factors of atopic dermatitis:
Although the predisposition for atopic dermatitis is genetically determined, several trigger factors may influence the outbreak of skin changes. These trigger factors include:
1)Respiratory allergy. In affected individuals, respiratory allergy to house dust mites, pollen and animal epithelia may cause an outbreak or worsening of skin changes if they come into contact with the allergen.
2)Food allergies. Food allergy is more frequent in infants and children with atopic dermatitis. In affected individuals, common allergens such as cow milk, eggs, fish, soy or peanuts may cause an outbreak or worsening of skin changes if they come into contact with the allergen.
3)Microbial agents. Staphylococcus aureus colonises more than 90% of AD skin lesions. Proteins of Staphylococcus aureus may function as foreign antigens, their exotoxins operating as superantigens and thus exacerbate AD.
4)Dry skin induced e.g. by long bathing, cold dry climate, insufficient use of emollients may lead to exacerbation of eczema.
5)Itching and subsequent scratching, creating a cycle
6)Sweating induced by e.g. impermeable clothing, hot work places or stress may lead to worsening of skin changes.
7)Chemical/physical irritants like smoking or clothes also may lead to exacerbations.
7a)Severe Psychological stress.

Research and Treatment.
Interleukin (IL)-10 plays a key regulatory role in allergic diseases. It is produced by many of the inflammatory cells involved in allergic inflammation, including macrophages, regulatory T lymphocytes, dendritic cells, mast cells and eosinophils. IL-10 suppresses allergic inflammation by inhibiting the expression of inflammatory cytokines, Helper Tcell(Th)2 cell-derived cytokines, chemokines and inflammatory mediator enzymes. In addition, it suppresses antigen presentation and increases the production of endogenous (internal) anti-inflammatory molecules.(exogenous =external)

There is increasing evidence for defective production of IL-10 in allergic diseases, including asthma and rhinitis and this is associated with disease severity. This may lead to amplification of the inflammatory response in allergic diseases. It may be determined by polymorphisms  of the IL-10 promoter linked to low endogenous IL-10 production. IL-10 itself may be a therapeutic approach to allergic disease, but because of side effects stimulation of endogenous IL-10 production may be a more useful approach.
NB: IL stands for interleukin.
Interleukins are a group of cytokines (secreted signaling molecules) that were first seen to be expressed by white blood cells (leukocytes, hence the -leukin) as a means of communication (inter-). interleukins are produced by a wide variety of bodily cells. The function of the immune system depends in a large part on interleukins, and rare deficiencies of a number of them have been described, all featuring autoimmune diseases or immune deficiency.
Scroll down on this link to IL-10 and it tells you which cells are involved.
Polymorphisms. This is a very important link because it is this that creates the predisposition in an individual.
Corticosteroids restore the impaired IL-10 secretion in asthma and specific immunotherapy increases IL-10 production by regulatory T cells. Novel therapies in the future might include drugs that selectively activate IL-10 signal transduction pathways.This is a link to my blog, which explains the function of each gene/cells of the immune system  above that I have made bold.
Title: Re: New Member
Post by: Aya on Thursday April 17, 2008, 04:21:38 PM
What is the best cream to control the itch? 
Title: Re: New Member
Post by: bunnie on Thursday April 17, 2008, 06:44:09 PM
Well you see bobby everyone is different, even though they may all have the same condition. That is why it is more often than not a trial and error situation to find out which treatment suits an individual best. There are lots of treatments used as you can see on the eczema board, it just depends which helps the best with your wife. Has she not tried any other treatments? Maybe she is itching (worse for everyone at night in bed I think ) worse at that time because her skin is too dry. Maybe she needs a deep moisturiser ( unperfumed etc) on top of the cream the doc prescribed. This helps the cream to be absorbed more effectively. If the stuff the doc has given her is not working, she should go back, and try another, and yet again if that doesn't work. Its best to go when the evidence is bad so he can see for himself. I personally do not have this condition, but I do know how and why it occurs as in my previous post. Treatments too are very much alike, concerning skin conditions.
Title: Re: New Member
Post by: Aya on Thursday April 17, 2008, 08:15:19 PM
Understand,  She has tried so many lotions and creams prescribed by her doctor and dermatologist I can't remember them all.  I know one thing that did work for her was she went to see her care provider here on the navy base and he gave her steroid shots in her feet.  She said it hurt like hell but the itch went away for 3 to four months.  She has done this twice.  I don't think it is safe to do that, but she went back wanting another shot, she was changed to a different provider since her old one has transfered and they had nothing in her record that was recorded that she was given these shots.  She couldn't remember the name of it either.  Anyways she takes Pro Topic, and two other creams for it.  She is good during the day time cause I think her mind is busy on other things, but at night she scratches alot which disturbes her sleep.  I went to Merry Clinic and ordered the herbal cream and pills, I have read alot of negative things that it doesn't work.  It hasn't arrived yet but thinking that I will send it back.  It was expensive, over $100.00 for this stuff!!! I can't afford that stuff every two weeks or month... and why use it if it doesn't work!!  Right now I bought Aveeno Oatmeal Bath in which she soaks her feet in it before bed time, hoping that it will relieve the itch.
    When we go back to Japan she will go back to her doctor she was seeing there whom I heard is one of the best, or well known, I guess he specializes in this stuff.  Hope she can get something there to help her.
Title: Re: New Member
Post by: bunnie on Thursday April 17, 2008, 10:09:00 PM
I am all for using steroids if it smacks it on the head for a few months! My condition too is unbearable itchy, as many other conditions are too, and I really feel if your wife can really get this deep moisturiser to put on top her cream it will help her sleep. Maybe she is getting too warm, at night in bed, and this is drying her skin out making it itch. I will try and find the links on this on here. I don't think that stuff you ordered will help neither to be honest, she'd be better off having the shots i think! As long as she is monitored well she will be fine I'm sure, and why suffer? Quality of life is very important, and when you can't sleep for the darned itch it is utterly miserable.
Rachels little girl has very bad exzema, and she has done this treatment , it works a treat. A few on here with unbearable itchy conditions do this regulary.,23477.0.html
Your wife will need the steroid cream , and a deep moisturiser. You need to ask the chemist about that because I don't know what is available in your country . Here in the UK it is called Doublebase, and it is used for exzema puritis in the elderly etc. Put a layer of steroid cream on, or whatever was prescribed, putting a decent layer , not thick , but then not too thin. On top of that slather on the deep moisturiser, lotion or gel. Put wet strips of gauze over all , or put on some wet cotton socks. Wrap the feet in cling film or saran wrap I think you call it over there? Or put feet in poly shopping carrier bags! It works great! If it is all dried out in the morning and the socks are stuck simply put the feet into warm water and they'll come off.