Paediatric Allergy
& Immunology
Diagnosis and Treatment of Asthma and Atopic Dermatitis (Eczema)

Asthma is a respiratory condition in which the airways of the lungs (breathing passages) narrow and swell, often in response to an allergen.

Asthma

Description
Asthma is a respiratory condition in which the airways of the lungs (breathing passages) narrow and swell, often in response to an allergen. This disease affects people of all ages, but usually starts in childhood. Air in the lungs travel through small airways called bronchial tubes. When the airways are clear, air moves in and out of the lungs easily. An asthma attack constricts the airways and interferes with the normal breathing process.

Causes
As people experience asthma attacks they learn to recognize specific triggers that contribute to these attacks and try to stay away from them. There are individual triggers for each person. Children exposed to certain triggers become highly sensitive which causes the lungs and airways to swell up and produce mucus. Some of the triggers include the common cold, weather changes, physical activity, and air pollutants such as smoke, dust mites, animal dander, and pollen.

Signs and symptoms
The common signs and symptoms of asthma include:

  • Frequent cough
  • Wheezing sound heard during breathing
  • Shortness of breath and coughing
  • Feeling of tightness in the chest
  • Pain in the chest

Diagnosis
Asthma can be difficult to diagnose. Your doctor will ask about the frequency of your symptoms and order some tests to rule out other conditions.

  • A lung function test (spirometry) is done to measure the amount of air exhaled.
  • Allergy skin testing may be helpful to identify allergens in people with asthma.
  • In younger children the diagnosis is done based on the information provided about symptoms because lung function tests will be inaccurate before 6 years of age.

Treatment
You must know as much as you can about asthma, its triggers, and how to recognize and avoid them. Avoiding the triggers and with the right medication, an asthmatic can have a perfectly normal life. Treatment of asthma includes prevention of symptoms and treatment of progressive asthma attacks. Your allergist may also prescribe two main types of medications, long- term control medications and quick- relief medications.

  • Long-term medications that can be taken every day help reduce airway inflammation and prevent the asthma symptoms.
  • Quick-relief medications provide rapid relief from symptoms during an asthma attack.

Inhaled short- and long-term control medications are used by inhaling measured amounts of the medication through inhalation devices.

  • The most common is the metered dose inhaler that uses a chemical propellant to carry the correct dose of medication out of the inhaler.
  • Dry powder inhalers (DPIs) do not use propellants but need a stronger and faster inhalation.
  • A nebulizer is a type of inhaler that delivers medications in a fine mist through mouthpieces or masks.

By visiting an allergist you can take control of your asthma and improve your quality of life.


Eczema

Description
Eczema is a general term used to describe a group of skin diseases in which skin becomes swollen, irritated, and itchy as in a rash. Eczema affects both adults and children, but is most common in babies.

Causes
The most common type of eczema is caused by allergy and is called atopic dermatitis. Eczema is not contagious; therefore it does not spread from one person to another. You are more prone to have eczema if your parents or family has a history of eczema and allergic conditions like asthma and hay fever. Eczema can be triggered by certain substances such as soaps, detergents, cosmetics, jewellery, or sweat. Humidity and psychological stress may also cause eczema.

Signs and symptoms
Eczema causes dry, scaly, red skin that itches or burns. It occurs on the face, neck, and the insides of the elbows, knees, and ankles. In babies, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck.

Treatment
Treatment of eczema aims at keeping the skin moist by applying creams or ointments. Corticosteroid creams are applied to decrease the inflammation. If itching is severe, oral antihistamines are prescribed. In some cases, a short course of oral corticosteroids (prednisolone) is given to control an outbreak of eczema. Cyclosporine is also used in certain cases. Ultraviolet light therapy is another treatment option for eczema.

Eczema cannot be cured completely, but you can follow these measures in order to relieve your symptoms and lessen the flare–ups. Such measures include:

  • Avoiding taking long, hot baths. Try to limit bathing to 5 minutes with warm water and a mild soap.
  • Apply a good moisturizer every day right after bathing.
  • Avoid contact with soaps, perfumes, detergents, or jewellery which irritates your skin.
  • Wear loose-fitting cotton clothes.
  • Wash your new clothes before you wear them.
  • Use cool compresses to help control itching.
  • Keep your fingernails short to prevent scratching.
  • Exercise and meditation can help those for whom stress triggers an outbreak.
  • Avoid physical activities that promote excess sweating if this triggers an outbreak.
  • Practice good skin hygiene habits.

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