Atopic Dermatitis

Atopic dermatitis is a pruritic disease of unknown origin. It is is an inflammatory, relapsing, non-contagious and pruritic skin disorder.

The disorder is characterized by eczematous lesions, dry skin, and thickening of the skin.


Atopic dermatitis may be associated with other atopic diseases such as asthma, allergic rhinitis, urticaria, acute allergic reactions to foods.

The skin affected by atopic dermatitis reacts abnormally to irritants, food, and the environment. The skin becomes red, flaky and itchy.

It is a familial and chronic disease and the symptoms can increase or disappear with time.

Causes:

Genetics - A family history of atopic dermatitis is often common.

Infection - The skin atopic dermatitis is colonized by S aureus. This can cause a flare of atopic dermatitis.

Hygiene - Hygiene may be a cause for atopic dermatitis.

Climate - Atopic dermatitis flares occur in different climates. Heat and cold are poorly tolerated.

Differential Diagnosis:

Contact Dermatitis - A localized rash or irritation of the skin caused by contact with a foreign substance

Lichen Simplex Chronicus- A skin disorder that leads to chronic
itching and scratching


Nummular Dermatitis - A form of eczema that is characterized by round-to-oval erythematous plaques

Psoriasis - A common skin condition that causes skin redness and
irritation

Seborrheic Dermatitis - An inflammatory skin disorder that causes scaly, flaky, itchy, red skin

Tinea Pedis - A dermatophyte infection of the soles of the feet and the interdigital spaces


Lab Studies:

Skin scraping for pathological exam may be helpful to exclude tinea pedis.

Biopsy may be helpful to show an acute, subacute, or chronic dermatitis.


Medications/Treatments:

Anti-inflammatory agents provide relief of inflammation of eczematous lesions.

Topical steroids are the mainstay of treatment

Mild topical corticosteroid - Hydrocortisone ointment 1%

Medium strength topical corticosteroid - Betamethasone valerate

Immune Modulators are medicated creams that are used for the treatment of atopic dermatitis.

Tacrolimus


Pimecrolimus 1%


Moisturizing -
Patients usually benefit from lukewarm soaks followed by the application of a moisturizer.

Other treatments -

Both hydroxyzine and diphenhydramine provide relief from itching. Antibiotics are used for the treatment with infection caused by S aureus.

New Blog Location!

We just wanted to let you know that we're in the midst of combining all of our blogs (Roanoke Foot Doctor, Blacksburg Foot Doctor, and Botetourt Foot Doctor) into a bigger, better one - if you'd like to keep following us and stay updated on all the fun foot facts and articles, please update your bookmarks to http://shenandoahpodiatry.blogspot.com.

Thanks for reading, commenting, and of course visiting our offices!

Dedicated to your happy feet,

Nancy Ann Ballhagen
Administrative Assistant, Blacksburg Office

Low Heels = High Style, Less Pain?

Kitten heels have appeared on the fashion scene, and fashionistas are rejoicing in the most comfortable footwear trend in quite a while! These shoes, a morph of stilettos and flats, offer the sophisticated look of high heels but with less discomfort. Kitten heels may have had their stuffy days, worn in bland styles in the workplace by 1980s working women, but the new styles are far from frumpy. In candy colors, pretty peep toes, or toughened up with hardware, these shoes are fun and, compared to last year's sky-high stilettos, comfy.

The New York Times is raving about this smart new style. “They give you the posture. They give you an elegant attitude right away,” says Giovanna Battaglia, fashion director of Italian Vogue accessories mags Vogue Gioiello and Vogue Pelle.

Low heels may be high on style, but how healthy are they for your feet? The real answer is all in how you wear them. While they give the wearer less immediate pain than high heels, there is still little support in most ladies’ dress shoes, even low-heeled or flat ones. Check that your dress shoes have sufficient arch support; if they don’t there are plenty of comfy (and stylish) orthotic options available in the foot care section of your local shoe store or drugstore. Some will fit invisibly into peep-toe or open-toe shoes; others are printed with fun patterns that you'll want to show off. Also, let your feet rest! Put your feet up or go barefoot when you get a chance, and wear more supportive footwear out in the yard, when running errands, etc.

In our offices we often see patients with foot pain due to wearing improper shoes constantly for long periods of time. You can prevent painful foot conditions if you make smart choices for your feet!

Cross Country Barefoot Encounter

Did you hear about the guy walking across the country barefoot?? Yes, you heard me correctly. Ron Zaleski is trudging across the US - BAREFOOT - to raise awareness about the need for mental counseling for all military personnel.

As a former military man himself, he is attempting to collect 1 million signatures for his petition along his back roads route to the west coast. The petition calls on Congress to mandate mental counseling for all military personnel.

Tuesday August 10 (just last week!) he passed through good ole' Buchanan, VA. Such a huge cause trampling right through our back yards. Our very own Roanoke Times had a chance to catch up with Mr. Zaleski and get an update on his journey.

Ron is giving everything he has to this cause including the health of his poor tootsies! Rex Bowman from the Roanoke Times reported that his feet were a "mess of broken skin and calluses." Not exactly the prettiest of mental pictures. He should definitely have stopped by to see us while he was in town. ;-)

Well, I just wanted to share with you a little about the barefoot walker's journey. If you'd like to follow him on his cross country trek, check out his website www.thelongwalkhome.org.

For more information visit our website www.roanokefoot.com

VT Foot Fumble

It was grim news for VT Football fans when they heard Nick Becton, starting left tackle, sprained one of his right toes. He is going to be on the sidelines for an undetermined amount of time and there is no guarantee he will be able to be back on the field for Sept. 6th - the big season opener against Boise State.

For those of you thinking - "Toe sprain? He's seriously out for that? Walk it off man!" Here's the definition of a "sprained toe" according to Aurora Health Care. "A toe sprain is caused by a partial tear of the ligaments that support a toe. Ligaments are strong bands of tissue that connect bones to each other." Now it sounds a little more serious than you thought, huh?

Toe sprains can be caused by any number of things, from stubbing your toe to suddenly stopping a run and causing your toe to jam into the front of your shoe. And people MOST at risk for this type of injury are people playing sports, dancing, moving on rough ground, or people with poor coordination or the tendency to be clumsy.

If you think there is any possibility that you may have a sprain of any kind, you need to immediately see a doctor. They will need to run tests and determine a course of treatment which will definitely include rest from whatever activity lead to the injury.

Check out this site for more info on this particular injury. Toe Sprain

You can also check our our website if you are not sure what is causing your foot discomfort or pain. We have some great info on several different common ailments that may be the culprits. Shenandoah Podiatry