The Exchange

Commentary and Observations from
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The Atopic Triad: Why It’s So Important to Collaborate With Colleagues

The Atopic Triad: Why It’s So Important to Collaborate With Colleagues

As spring approaches, there is an entire subset of seasonal medical problems that can affect our patients. Especially in dermatology, it is quite common at this time of year to see a large influx of patients with atopic dermatitis (AD). This classic skin condition is included in the "atopic triad" along with asthma and allergies. A wide range of environmental factors, such as pollens, contact allergens, stress, food, skin flora, and humidity, play roles in the development and severity of AD. Up to 80% of children with dermatitis, also known as eczema, have the atopic triad—which elevates the importance of collaboration with our asthma and allergy colleagues.

Atopic dermatitis affects more than 9.6 million children and about 16.5 million adults in the United States. It is a chronic condition that can come and go throughout a patient's lifetime. The immune system becomes overactive due to a certain trigger, such as environmental allergies, and the inflammation that ensues damages the skin barrier. Itching is the hallmark of AD; erythematous scaling patches and plaques can develop anywhere on the body, with the antecubital and popliteal fossa being the most common sites.

A mainstay of management for the atopic triad includes avoiding known triggers. This is where collaboration between dermatology and allergy practitioners can have a positive impact on patient outcomes. In dermatology, we treat the signs and symptoms of AD, but we need the input of our allergy colleagues to not only help identify the patient's specific triggers, but also to assist with identification and treatment of asthma—including the administration of immunotherapy, if warranted.

When treating chronic immune-mediated disorders, we must remember that they are like puzzles with many different pieces. Usually, a single medical specialty alone cannot address and treat all the different aspects that are involved. Therefore, it is so important to keep an open mind and collaborate with our colleagues to allow patients to receive the best possible understanding and control of their disease.


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Filed under: Allergy/Immunology, Dermatology

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