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Protection Discussion Board

Atopic Eczema


Atopic eczema is the most frequent severe inflammatory skin condition, involving more children than adults (Traidl et al., 2021). Although the pathophysiology of this disorder is not fully known, various factors play a role in its development. Genetic causes, a deficit in epidermal barrier failure, immunologic disorders, altered immunological response, impaired skin microbiological balance, and environmental variables are among them (Kim et al., 2019). In terms of genetics, it has been proven that loss-of-function mutations in the filaggrin gene contribute to the existence of this syndrome (Eichenfield et al., 2022). Filaggrin, which is found on chromosome 1q2 and encodes the FLG (filaggrin protein), collects keratin filaments into compressed bundles and influences the shape of keratinocytes and the granular cell layer. This connects to the lamellar bodies and reduces the availability of filaggrin metabolites, resulting in skin moisture and pH alterations. This increases the activity of serine proteases and kallikreins, resulting in corneodesmosome depreviation and intercellular adhesion (David Boothe et al., 2017). These processes also promote Th2 inflammation and allergen penetration via the skin.

This disorder is characterized by xerosis, pruritus, thickened skin, and eczematous lesions. The symptoms can arise in different parts of the body or in the same places. The location and appearance of the rash change with age (Schmitt et al., 2013). This illness is identified using patch testing after a successful physical examination to identify particular types of allergens causing the dermatitis. A skin biopsy may be ordered if the clinician is unable to diagnose the condition with a physical exam or patch test (Holyoak, 2023). This condition has a long duration that varies with age. This condition often begins and ends in youngsters between the ages of 5 and 6, with recurrent flare-ups. This disorder, on the other hand, is generally chronic (Pan & Su, 2022).


To treat atopic dermatitis, cyclosporine and tralokinumab are two of the medications that are typically prescribed (Adbry). The anti-inflammatory effects of cyclosporine are achieved by the medication’s ability to block the generation of cytokines (Lam et al., 2020). Hypertension, decreased renal efficiency, and elevated blood lipids are some of the most common adverse effects. Because of this, the nurse is required to check the patient’s blood pressure and evaluate their renal function before administering this drug. In contrast, IL-13, a crucial protein that drives the symptoms of atopic dermatitis, is the target of the drug tralokinumab (Adbry) (Schneeweiss et al., 2021). Rash and altered eye vision are examples of adverse effects that frequently occur. Before prescribing this medication, nurses should evaluate the patient and make sure the patient is aware of any potential adverse reactions to the drug.

Nursing Interventions

Improving the skin’s integrity and reducing the frequency of dermatitis symptoms is the first step in the therapeutic process. Because of this, irritants and allergens that trigger an inflammatory reaction in the skin should be avoided (Kim & Choi, 2023). Patients who have this illness are at a higher risk of developing infections as a result of a breach in the skin’s integrity, abrasion, and acute inflammation; therefore, preventing infections is another intervention that can be utilized. Monitoring the patient’s skin and advising them not to scratch the affected regions are also important parts of this intervention.


Even if the etiology of atopic dermatitis is not fully known, medical professionals still need to possess the essential abilities in order to correctly diagnose patients and provide the proper drugs. In addition, it is essential to evaluate patients before prescribing medications in order to eliminate the possibility of unfavorable results. In order to attain the outcomes that are sought for care, each nursing action should be prioritized.


Eichenfield, L. F., Stripling, S., Fung, S., Cha, A., O’Brien, A., & Schachner, L. A. (2022). Recent developments and advances in atopic dermatitis: A focus on epidemiology, pathophysiology, and treatment in the pediatric setting. 
Pediatric Drugs
24(4), 293-305.

Kim, B., & Choi, S. (2023). Nursing interventions for children with atopic dermatitis and their families. 
MCN: The American Journal of Maternal/Child Nursing

Kim, J., Kim, B. E., & Leung, D. Y. (2019). Pathophysiology of atopic dermatitis: Clinical implications. 
Allergy and Asthma Proceedings
40(2), 84-92.

Lam, M., Zhu, J. W., Maqbool, T., Adam, G., Tadrous, M., Rochon, P., & Drucker, A. M. (2020). Inclusion of older adults in randomized clinical trials for systemic medications for atopic dermatitis. 
JAMA Dermatology
156(11), 1240.

Pan, H., & Su, J. (2022). Association of probiotics with atopic dermatitis among infant: A meta-analysis of randomized controlled trials. 
Oxidative Medicine and Cellular Longevity
2022, 1-7.

Schmitt, J., Langan, S., Deckert, S., Svensson, A., Von Kobyletzki, L., Thomas, K., & Spuls, P. (2013). Assessment of clinical signs of atopic dermatitis: A systematic review and recommendation. 
Journal of Allergy and Clinical Immunology
132(6), 1337-1347.

Schneeweiss, M. C., Perez-Chada, L., & Merola, J. F. (2021). Comparative safety of systemic immunomodulatory medications in adults with atopic dermatitis. 
Journal of the American Academy of Dermatology
85(2), 321-329.

Traidl, S., Werfel, T., & Traidl-Hoffmann, C. (2021). Atopic eczema: Pathophysiological findings as the beginning of a new era of therapeutic options. 
Allergic Diseases – From Basic Mechanisms to Comprehensive Management and Prevention, 101-115.

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