Atopic Dermatitis-SKIN DISEASE

* The article is long, but worth it to read in its entirety. But if you're just looking for recipes, scroll to the bottom of the article :).
Atopic dermatitis is not new in human history, no pronounced increase in the number of patients, especially in modern societies, a major challenge for medicine. Many questions and controversies spring up more than you find answers. What is the cause of the rise in recent decades? Is there a permanent cure or not? How to develop new drugs that will expand the very narrow range of pharmacotherapy for this disease? Such academic debate, unfortunately, do not use patients, especially the youngest of atopic dermatitis and the most affected. The painful fact is that today we have better treatment for some types of cancer, but for atopic dermatitis. In fact, most dermatologists include dermokozmetiku in therapy, so this area is becoming very profitable. And it relies on traditional dermokozmetika phytotherapic treatments.

At the time of the general arguments of modern medicine and complementary wisdom and experience of integrative medicine teaches us that in the case of atopic dermatitis may well help the combination of pharmacotherapy and modern knowledge and modern medicine in komplementernoj. Not without reason the disease. The most painful and most difficult of all issues still lies in the fact that our level of psychosomatic illness on to say. Here we touch upon this problem we just atopic dermatitis may help you reflect a little about yourself.

What is atopic dermatitis?
The former name for neurodermatitis, we will see, is well described at least one group of causes of atopic dermatitis. Atopic dermatitis (AD) is an inflammatory skin disease characterized by several features:

- Kseroza, or dryness of the upper layer of skin with the appearance of scaly skin, accompanied by increased fluid loss through the epidermis (engl. TEWL) and increased skin sensitivity to common environmental agents such as detergents and chlorinated water
- Erythema (reddening) caused by inflammation, which is a mechanism other than erythema in diseases such as rosacea
- Pruritus (itching), induced by inflammatory mediators and that causes the need to scratch the skin - which further exacerbates inflammation and destroys the quality of life
- A frequent association with allergic diseases (so called Th2 disease, see the article on allergies and immune system), such as allergic rhinitis and asthma, and food allergies
- Reduced resistance to bacterial, and fungal and viral colonization of the skin, caused by an imbalance in the immune system

In the background lies the multiple causes of disease. Historically, even the ancient Chinese described the symptoms of this disease, and the Roman Emperor Octavianus Augustus perfectly described the association of atopic dermatitis and allergy, which is called seasonal rhinitis (sneezing). The term atopy invented by the authors of Coca and Cooke, with the help of linguists Edward D. Perry, 1923. year. Examining patients' hyperresponsiveness to antigens (substances) found in some patients, abnormal skin sensitivity to the whole set of substances, so they decided to take the Greek word? About? And?, To describe the "strange and eccentric disease." Probably not even aware that they describe a disease that will hit in today's age is probably 20-30% of the population, the prognosis worse in coming decades.

The disease occurs in adults and children, and often begins very early, several weeks to months after birth. 45% of patients develop AD within the first 6 months of life, but there are cases where it occurs in adulthood. There is a characteristic skin dryness and redness. It can be located on the face, neck, often on the elbows and behind the knees (bend legs), and unfortunately, it can develop throughout the body.

Atopic dermatitis is a hereditary disease

It has been shown that a history of atopy in the parents increases the risk of development of atopy in children. There was also evidence that the increased risk of maternal inheritance, and less than a father. This means that the greater the possibility of development of AD in children whose mother has AD, and less likely if only the father has AD. Interestingly, the possibility of development of AD in children is inversely proportional to the number of children, and this means that a larger number of children a couple fall risk for children to develop AD. No - it's all just a statistic. Although often spoken of the correlation between AD and asthma and allergies, it is valid only for the person with AD, and is not associated with parental asthma or allergy. In other words, if
parent has asthma and / or allergic rhinitis without AD, there is increased risk that the child will develop AD. It is a proven and modern genetic studies. Initially these were epidemiological studies, and later found in the modern analysis of genetic material called. Techniques of SNP (Single Nucelotide polymorphism, a polymorphism nukletoida) reveal that mutations at the level of the entire genetic material, or genome. It was found that there is a separate set of genes to the risk of asthma and allergic rhinitis, and to develop a separate AD.
Genes involved in the increased risk, as expected, they are encoded (containing information for the synthesis) of inflammatory mediators ...
Genetic predisposition for developing AD hundred years ago were almost statistically the same as today, can not be explained by these factors, a significant increase in AD in the last decades. Obviously, other factors play a role and that the matter will be discussed later.

Atopic dermatitis is a disease of the immune system imbalance

In a previous article about allergies and immune system, but we wrote a lot of allergy. In a similar way, a problem with AD. Begins to dominate so. Th2 immune response, characterized by the presence of the aforementioned interleukins 4, 5 and 13 The response in the body serves as a defense against parasites, but in this case contributions, as well as in allergy, inflammation and tissue damage with no biological meaning. This has prompted some people on the internet to talk about the AD-like autoimmune disease. But this is not true, it is an infection induced immune imbalance. Amplification of Th2 responses detrimental Th1 response, which is responsible for defense against bacteria and viruses. The so-called naive T cells, those that are not yet met with the antigen against which to contend, as the signal gets to your turn to answer. In fact it managed, at least in part, so. dendritic cells and that it presents (a) that antigen. In allergy and AD, the resulting excess Th2 lymphocytes, an increase in the production of IgE antibodies that grow in the type of allergic response, and with it comes to attracting other inflammatory cells in the skin that cause all the symptoms of AD.
As with allergies, and in AD and there is so called. hygiene theory as one of the factors that caused increase in the number of patients with AD. Specifically, it is believed that the Th2 system is predominant in human biology, and that the continuous presence of bacteria and viruses enhances the Th1 response over time. In today's era of general sterilization, fears of bacteria, but probably the presence of many preservatives in the diet and preraširene of antibiotics, there is in modern societies to "collective" Th2 shift, and an increasing number of diseases caused by this imbalance. Interestingly, the children grew up in rural areas have a lower incidence of AD, and proved that the urban children who spend at least some time in the countryside are less likely to develop AD. One reason perhaps lies in the bacteria encounter more frequent in rural areas, which need not necessarily be dangerous. However, part of the secret may lie in less than the rate of pollution in urban areas. Interestingly, according to one study, children who are fed organic food rarely develop AD, which is confirmed by the fact that we so polluted our land and food, let us now return like a boomerang, which is the worst of our children.
In addition to Th2 shift, the immune system imbalance occurs at the level of fossil ever, but highly effective innate immune system. One group of proteins, such as defensins, which act antibakerijski on which we will discuss in the next section of the article. The second group are special recipes that part of the immune system, which are less effective in the AD. These are, for example, Toll like receptor (TLR) 2 and 9, and NLR receptors. They recognize the dangerous proteins and lipids from pathogenic bacteria promote the fight against them, and balancing the immune response. Those in the AD's are becoming less functional and less responsive to stimuli. As a result of amplification of inflammation occurs, and the development of infection is a major immune problem in AD.
The immune system is the main goal of today's medicines. It is mainly about class immunosuppressants, most commonly corticosteroids.

Atopic dermatitis is an uncontrolled infection
At a time when medicine is controlled by corticosteroids AD, this disease generally perceived only as an inflammatory disease. Indeed, due to the imbalance of immune system, inflammatory mediators of Th2-type cytokines, which are generated in large quantities, reducing the natural creation of a whole group of ancient proteins that play a role in innate immunity. These proteins, called antimicrobial peptides, or prevent dangerous microorganisms that endanger skin. We will mention a few:

- Cathelicidins LL-37
- Dermicidin
- A group of proteins ß-defensins, HBD-1, 2 and 3

As an ancient way of defense against microorganisms, these proteins are very effective, but that Th2 system hampers their creation. It is therefore not surprising that a very high percentage of patients with AD has a large number of bacterial species Staphylococcus aureus, or pathogenic bacteria. He knows more than 10 million per square centimeter in the inflamed areas of skin in AD. Although apparently the presence of a bacteria might even act favorably, because it stimulates the Th1 response, it is unfortunately not happening. Let's look at why this is so. This type of staph is very awkward, because it contains a protein called superantigen. Superantigen have the ability to activate T-lymphocytes, including the accumulation of Th2
lymphocytes and thus even exacerbate inflammation. In addition, the presence of staphylococci attracts an increasing number of immune cells and immune system fall into the trap: it comes more immune cells, but they do not stimulate a response against mikoroorganizama, but rather more damaging tissue and further reduce the regulated immune systems, such as defensins. Furthermore, this activated cells become resistant to the action of major classes of drugs against AD, corticosteroids. It is sometimes the reason for persistent cases of AD who respond poorly to corticosteroids (refraktornost to corticosteroids).
In addition to staphylococci, the deterioration of AD's influence and other microorganisms. These are the most common species of the genus Candida, and species of fungi Pytirosporon ovale, and species of the genus Trichophyton. A possible decrease in inflammation in Candida infections, but we wrote the article on Candida.

Although it remains doubtful that it causes, it is known that its presence enhances the Th2 response and can exacerbate inflammation. Type Pytirosporon ovale, or so. lipophilic fungus whose number grows during puberty, surely worsen the clinical picture, especially in the area where it normally has many, such as neck, face and upper trunk. And it encourages the development of Th2 Then answered
a worsening of AD in early puberete perhaps we can explain this fungus.
Some viruses can worsen the state of AD, including the herpes virus, vaccinia virus, parainfluenza viruses, and very common Epstein-Barr virus (the cause of infectious mononucleosis), cytomegalovirus, and the common cause of respiratory infections, respiratory sinkcicijski virus, which is normally recognized and a virus that complicates the situation asthma.
Deterioration AD viruses and vaccines based on viruses, the public is alarmed 1948th year. The vaccinia virus used in vaccines to protect against far more dangerous smallpox virus, was strongly aggravated the clinical picture of patients with AD.
Public Health has been advised that such children are vaccinated or not, or after the period of vaccination observed in the preparation of a possible deterioration. On the Internet, even in the medical section of the public, it still can be heard warning that the increase in AD and possibly caused by a growing panel of immunization of young children. It's not clear how much this is true, but our experience with vaccinia according to at least consider all aspects influence the immune system in children with AD.
The infection is too overlooked the cause and component of AD, especially in clinical dermatology. Although there are a whole series of papers that talk about improving clinical use as antibacterial, and antimikotskih (anti-fungal), drugs, in today's practice, it is all too rare. Individualized diagnosis and therapy may be true, and the main road to better treatment of AD, but unfortunately it is rarely encountered.
In the context fitoaromaterapije, infection, rather colonization of the skin by pathogenic bacteria and fungi, would be an ideal solution to essential oils. Oils like tea tree, palmarosa, thyme geraniol and linalool chemotypes, and similar oils, show a wide spectrum of activity against bacteria and fungi. Unfortunately, the use of essential oils is not desirable in the AD, because atopic skin is prone to react violently to the molecules that are found in essential oils, as well as the many other fragrant substances, synthetic or natural. It does not mean that all such patients respond, but experience teaches us that this precaution more than justified. We suggest the use Hydrolat, such as thyme linalool chemotypes and tea tree (see below How to make a tonic Hydrolat), but they should be used wisely and with a lot of precautions, the monitoring of individual responses.

Atopic dermatitis is a problem of diet

Despite all the theories, we can achieve consensus on how eating habits are certainly not the underlying cause of AD. However, numerous scientific papers talk about allergic reactions to food as a factor that exacerbates AD. It seems that AD as a disease that directs the Th2 response, and causes a systemic problem, and leads to the development of allergies and / or intolerance to certain antigens from food, just as children with AD and develop an allergic reaction to pollen.
In the ideal case, diagnostic, patients with AD, especially adults, and children aged 2-3 years, it would be useful to make the overall profile of IgE (allergy) and IgG4 (intolerance) of blood. This examination shall examine whether the organism is created by a series of antibodies to common foods, milk, eggs, grains and fruits and vegetables. Usually a series of panels examining 80-120 foods. However, it is the ideal case. In our clinics are typically examined profiles of IgE, and the relatively limited set of ingredients. Therefore, parents and adult patients often remains that they have to pay these tests.
The most common foods to which they appear immune reactions are milk, or casein protein from milk and eggs (ovalbumin from eggs). Followed by soy, gluten and other proteins from wheat, barley, peanuts and chocolate. As mentioned, ideally for the entire profile IgE/IgG4 antibodies, and then expelled from eating foods that are developed against the immune response. Due to the high cost of these tests, many are trying to "blindly" throw out the most problematic eating foods such as milk and eggs. It is therefore not surprising that some patients are helped to decide to go on a macrobiotic diet, in which the eggs and milk are strictly avoided. However, a relatively big problem is allergies / intolerances to some of the grains, which dominate in most schools, a healthy diet. So there is quite a complicated scheme in which the diet is also blind, throw ovalbumin, casein-gluten-soy complex foods. This scheme is complicated because most foods, from veggie to all others, these foods contain.
I would not want to discourage, but maybe it's better to make a search that will cost as much and a little more dermokozmetike set for a few months of use.
As you can see, višeuzročna AD is a disease, so the removal of undesirable ingredients may be only a small wheel that will help the whole story, but there will be a magic wand that will solve everything.
If you think you do, well you can do. Your doctor may request at least a diagnostic profile of IgE (allergy), which goes at the expense of health insurance. What surely benefit many patients, both small and great, is the ejection of casein (milk and all dairy products, including yogurt and cheese). This applies to the goat and sheep milk. Not to be confused intolerance to lactose in milk, which is the problem of enzyme deficiency that results in the inability to complete the decomposition of lactose from milk, the immune intolerance to protein from milk! So people who are allergic / intolerant to milk, should not take any now available lactose-free milk! Animal milk is best replaced with oat milk, which is naturally sweet and delicious, the year the gastrointestinal tract, rich in beta-glucans celebrities who, interestingly, just the one part and stimulate the immune system that is deficitan in the AD. Milks are preferred because the soy milk, now very popular, also reported allergy and intolerance, thus avoiding unnecessary problems. Children are quick to adapt to, and given that there are now oat milk tastes different, after all come to love this healthy exchange. Good nutrition is out of chocolate (most of the milk chocolate), and peanuts. The diet we should throw all canned, because konzervasni known allergens, and with all the burden on the liver. These are cured meats, pates with preservatives, and other juices and canned foods, and various instant foods that dominate the shelves of our shops. It is said that organically grown food helps with AD. How much is available, or if you obtain from trusted local sources, try to make this substitution.

If we think about food as medicine, it is necessary to adjust the ratios and intake of essential unsaturated fatty acids (EPA, DHA, ALA, GLA, see the text of omega acids), and the intake of probiotics in high doses. This will be discussed in the section that discusses the treatment of AD. The diet is useful to introduce, depending on age, and supplements (supplements), the most common vitamin. Possible to precisely define who we are vitamins and other essential substances in the deficit, the so-called tests. orthomolecular medicine, where the blood and urine metabolites to determine the physical accurately tell whether there is any nutritional deficit. Do not confuse it with "the determination of vitamins and minerals," which was popular with us: these searches are, in essence, the questionnaires are very imprecise, with no biochemical basis.
Search orthomolecular are expensive, so if you have them you can not afford enough food suplementirati a good multivitamin, a vitamin that can really help in some cases, natural vitamin E. He prescribes a larger dose, it can not hurt, but it is very important that it takes a natural,? - (+)-tocopherol, rather than synthetic versions of vitamins.
In oligoterapiji used very often manganese, and combinations of gold-copper-silver. These products in our no. It is important to remember that changes in diet and supplements are not a guarantee of healing, but in some patients give good results.

AD disbanans hydro-lipidic barrier of the skin
Leather is a very effective barrier that prevents the loss of fluids and dissolved substances in our blood and intercellular fluid, while simultaneously protecting our body from the harsh environment of mirkoorganizama. Stratum corneum, the top layer of skin, its structure is reminiscent of the brick wall where the bricks were apparently dead top layer of skin cells, and intracellular molecules behave like cement between the bricks. In AD, the findings suggest a number of problems.
We are already in genetics and inheritance filagrinu talked about as one of the genes in some patients, responsible for the problems of insufficient tightness of the skin layer and gubtka fluid through the skin. Other proteins are important here, as Spink-5, and cystatin klaudina-1, but clearly the problems of individual patients with one of them to be more pronounced, and what exactly is the story of an individual patient to patient. Since lipids that protect the skin, most prominent is the lack of ceramide and sphingosine, two lipids that have many functions, the antibacterial function to retain moisture in the skin. However, the worst cause of skin permeability is usually scratching of the skin due to itching. It makes the already damaged skin and stanjenoj mikroozljede, which in turn increase inflammation.
Whatever were the causes of individual, and leads to fluid loss through the epidermis, kseroze, and later of infection. Increased permeability of this barrier leads to the entrance of particles of pollen and other allergens and irritants, and in patients who have problems with allergic diseases, this leads to a seasonal deterioration of the skin. In addition to pollen, reduced bandwidth leads to the entry of pathogenic bacteria and fungi, which were discussed in the previous section.

Therefore, the conventional therapy often occlusive:
spreading waxes that covers the skin (in phytotherapy is to use shea butter), and even physical occlusion foil or paraffin gauze. Jake occlusion (foil) are a temporary solution, it is better to conduct medical surveillance, and if there is no reduction in inflammation, these measures have limited effect. Milder occlusion, such as shea butter, suitable for everyday use and do not require professional supervision.
The observed lack of ceramides in the barrier and led the creation dermokozmetike with ceramides, which has also shown some success in treating AD, but without complete removal of the cause, these measures have no lasting effect.

Itching, unbearable itching
Apart from the aesthetic appearance of the skin, a factor that most crashes quality of life is itching. Typically, the resulting period of "attack", a typical night and worsening itching of the skin, which culminates around 3-4 am. Therefore, both small and large patients have a problem, and lack of sleep and fatigue only further worsen the clinical picture and lead to "bloody circuit" itch that encourages lack of sleep and sleep deprivation that promotes itching.
The mechanism that lies behind it is very complex. In the classical allergic contact dermatitis, in which inflammation and itching resulting from skin contact with allergens, the local hormone that causes him to histamine. The application of antihistamines for allergies quickly helps. However, in AD, the picture is different. The main local hormone that stimulates histamine itch did not, but the entire series as local hormones and transmitters (messenger) released by nerves in the skin. Since leukotrienes, prostaglandins, acetylcholine, opioids, can all be included as an internal cause. Therefore, the use of antihistamines with no greater benefit in most patients, although it is widely prescribed. Some seem to realize, because acting sedative effects, especially the older generation antihistminika, and some patients respond well to know them, so it is always worth a try. This bar also make it easier to sleep and soothe itching.
The itching and affect sex hormones in girls pogotvo which begins with the menstrual cycle, hormones, or begin to grow in the prepubertal period. Then for some means to perform and worsening symptoms.
There are many external and internal factors that start this unbearable symptoms. Soaps and other means of personal hygiene, chlorinated water, dry skin, sweating, traces of detergent and softener on clothes, food contact on the skin, pollen, hair, feathers and pets, dermatofagi in house dust, mikoroorganizmi about which we have already said, the heat and cold, wet and dry weather, and other sex hormones, and finally - psychological mood. In this kakafoniji possible causes, it is almost impossible to find the right guiding principle.

However, there are some practical tips:
- Change the detergent and fabric softener. It is difficult to find a "hypoallergenic" detergent, but one with less odor is always preferred. In addition, flushing and strong spin (1000 rpm), but are standard in programs for children and babies of modern washing machine. If necessary, avoid fabric softener, our old without it quite well lived.
- Examine whether there is an allergy to pet hair and feathers, if the house has.
- Clean the house dust. The problem is not the bacteria in the home, so do not use a bunch of chlorine-based antispetika that anyway exacerbate the situation due to irritation of the skin.
- Boil water for swimming, especially if children are involved. The remains of chlorine in water can act as an irritant.
- Throw out everything that creates unnecessary chemical pollution. These are the various air fresheners, cigarette smoke (!), Disinfectant sprays, harsh detergents. Lime in the bathroom can be very well cleaned with citric acid, or preparations containing it.
- Hygiene, use as few resources. Today everything is sold as a natural and Soothes, but definitely avoid anything that contains soap, natrijlauril sulfate, and even Lauret sufat sodium or sodium sulfate Paret. Such funds shall not contain parabens, and preferably no konzervasne like fenoksietanola. For babies, and usually boiled water is quite good.
- How much life as possible, make changes to the hot and cold, let it be less shocking to the skin. Especially if you have noticed that it bothers you or your child.
- Say "be careful how you feel, you or your child, be stress-free" would be empty phrase. We will devote a special title in psihosomatici.
The official medicine admits a natural substance as a great antipruritik (anti-itching agent), and it's menthol and essential oils rich in menthol like peppermint.
There is a need, as with all essential oils, be careful. Although cooling reduces the itching, this effect was relatively short lived (lasting up to several hours) in patients with AD, after a brief improvement, known to follow an even greater deterioration. Furthermore, menthol and menthol essential oils are completely banned in babies and young children. It is important to know because many herbalists know how to make vaseline grease with menthol for small children, which is not good. Menthol can cause respiratory problems and even respiratory failure in very young babies. Just as in the case of tea tree, is a menthol oils should be very careful and monitor individual responses.

Atopic dermatitis is a psychosomatic disease
Today is a very popular Psychosomatics - all who come to us saying that they know that all diseases "in my head." While diseases such as cystitis, not to say accidents like fracture of the hand, it is difficult to explain physically or medically substantiated connection with the psyche, AD is probably the most confirmed psychosomatic illness.
That there is something the doctors and scientific confirmation before noticed that stress means precede exacerbation (worsening) diseases, just as a sudden shock in seconds can stop itching horrifying attack. Today we know how stressful factors causing the release of neurotransmitters, local messengers from nerves in the skin and they may act on immune cells. Two major, acetyl-choline and substance P, were determined as the main transmitter of "bad mood" in the skin, but there are a number of similar molecules that are suspected to participate in this process. Nerves use neurotransmitters, in addition to directly causing itching, and encourage the accumulation of inflammatory cells into the skin to secrete substances that do harm. It is believed that stress, whatever it was, affects the skin and through the adrenal glands and secretion rhythm of its own corticosteroid hormones, which in turn controls the immune response.
From the aspect of traditional Chinese medicine, atopic dermatitis is a problem, and liver. In classical medicine, diseases of the liver and accumulation of bile acids in the bloodstream cause itching, but in the case of AD, it is not associated with bile acids, but very rarely. The immune and psychosomatic terms, the liver is the organ of tolerance - the immune reduces the number of lymphocytes that cause allergic type responses, in terms of psychosomatic liver is the organ responsible for the internal toleration. That is why most homeopaths, physiotherapist and a variety of other moves often act on the liver.
The skin has a very interesting psychosomatics. According to Chinese medicine, it belongs to metal element, the element that speaks of the deepest in touch with us. And as for the temptation of the body surface. A lot of the symbolism of the skin. So I give in this article I give an extract from the revised book on cosmetics, with the main aspects of the psyche that carries leather.

The authority is the first symbol of the skin. Deep inner authority. In the age of the crowd
pseudo, which included politicians, media stars, people with academic degrees, religious leaders, managers and others, very few people truly understand what it is authority. The concept of authority is very important especially for parents who have authority for their children - you have spoiled a sense of authority in itself, it will transmit to their children. A child may be spoiled rebel against your values ​​- if not the words, then this will show her skin. It has become normal to consider the imposition of authority and domination. This is incorrect. The real authority only encourages, inspires other authority. He does not need to prove to anyone, not to stand out - whoever he is. First, then, comes authority, and then out of it, such as foundations, grows - ego. The modern, however, the time the ego grows out of nothing, or growing out of partial authority. When we look at the real authority, it does not diminish our value. When we look at pseudo, then we think that we are not able to be such. That we can fulfill a sense of admiration for pseudo, but deep down we feel anger because someone else is more capable than us.
The anger against someone who is more capable than us in the collective consciousness through texts boil in a newspaper that in an offensive way of talking about the juicy details of this pseudo-life, with endless gossip posprdnih. Then floats to the surface all the resentment toward those who seem to worship or admire them. All are guilty, and those who present themselves as pseudo, but we who are constantly seeking a better and more capable than us: the football team, a famous singer, top scientists, heads of state.
Now forget about such behavior. The skin can not tolerate it. Interestingly, just as in cosmetics evident denial of authority. Commercials obasipaju you with what you have to apply to your skin. Throw away that someone else thinks of you and for you.
Authority implies that the parents themselves take responsibility for treating children from AD. Take advice, but do not be foolish. I remember one of the worst cases of AD who remember where they all pomučili with very little success.

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