Overview

Atopic dermatitis (eczema) is a chronic inflammatory skin condition causing dry, itchy, inflamed skin. It is one of the most common skin diseases in Kuwait and the GCC. It is not contagious, but tends to flare periodically. Part of the "atopic triad" with asthma and allergic rhinitis.

Symptoms

• Intense itching, often worse at night
• Dry, rough or scaly skin
• Red to brownish-grey patches on hands, feet, ankles, neck, eyelids, elbow and knee folds
• Raised bumps that may weep fluid when scratched
• Thickened, cracked skin

Causes & Risk Factors

• Filaggrin gene mutation impairing skin barrier
• Immune system overreaction to environmental triggers
• Kuwait triggers: extreme heat, air conditioning, sand/dust, hard water, harsh soaps

Complications

• Bacterial, viral, and fungal skin infections
• Sleep disruption from itching
• Asthma and allergic rhinitis risk in childhood
• Anxiety, depression, and reduced quality of life

Diagnosis

Diagnosed clinically via medical history, physical exam, patch testing, IgE blood tests, and occasionally skin biopsy to rule out other conditions.

Treatment

• Thick fragrance-free moisturisers applied immediately after bathing
• Topical corticosteroids for flares; calcineurin inhibitors (tacrolimus) for sensitive areas
• Dupilumab biologic injection for moderate-to-severe cases
• Antihistamines, antibiotics if infected, narrowband UVB phototherapy

Prevention

• Moisturise daily, especially after bathing
• Avoid personal triggers: heat, sweat, certain soaps, stress
• Wear soft breathable cotton; shower after sweating in Kuwait's climate

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