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That annoying rash may be skin asthma

By DR. GRACE CAROLE BELTRAN, The Philippine STAR Published Jul 20, 2021 6:00 am

Tony suffered eczema, along with pulmonary asthma, his entire life. He found it to be quite a nuisance, but more so once he reached high school.

“I suffered from this annoying rash on my arms and legs,” Tony said. “It took going through so many different medications to find out what irritated my skin, or made the itch a thousand times worse.  As a young kid, the urge to control myself from scratching was non-existent, to the point where my arms and legs would bleed, leaving bloodstains all over my bed.”

Luckily, it’s gotten better over the years into his adulthood.

“Everyone is different, and has varying needs, but don’t let your condition control your life,” Tony said.

Treatments available must focus on relieving rather than stopping the symptoms. Topical creams can soothe itching and a doctor may prescribe a mild corticosteroid cream. Lotions will also help relieve dryness and can lessen the symptoms.

For Belinda, who has always dreamed of walking down the aisle with the man of her dreams, “Eczema impacts my quality of life and overall life experience in ways you don’t think about every day.  My eczema gets so bad on my hands and gets between my fingers and itches and then it swells. These little things that you don’t think about much sometimes can affect you in a most unusual way.”

Shares Renee, “My husband has had rashes his entire life.  It’s been hard to see him so uncomfortable over the years. We’ve often cancelled weekend plans because his rash has been so bad, or simply just to prevent a flareup.”

Renee’s husband was finally able to work with his doctor to start a biologic medicine (a drug for many indications).

“It changed everything. He finally has some relief. Watching my husband deal with his severe eczema and seeing it becoming less responsive to treatment in the past couple of years, I would encourage anyone with eczema, especially a severe one, to partner with your doctor to find solutions that can really work for you,” Renee says.

These are just a few stories that I found on the internet. The one thing common to these people is that they all have skin asthma.

What causes skin asthma?

Environmental allergens like certain foods, pollens, or pollutants like smog can trigger a reaction. Likewise, physical irritants in the form of harsh fabrics or dry skin can trigger a reaction, too.

By far the greatest cause, however, is genetic. Some figures cite that up to 70 percent of all cases can be blamed on heredity. This may be due to a genetically challenged immune system or a recessive gene that may make a child more likely to be troubled by allergens, which can then trigger a more serious attack like skin asthma.

The good news is that it is almost always confined to the childhood years and outbreaks will subside, unlike other conditions like gluten psoriasis or other ailments, which may require an entire lifestyle change throughout adulthood to control.

Hot, humid conditions provide the perfect breeding ground for asthma allergens. Dust mites, mold, and pollen are all common triggers for people with allergic asthma. Those allergens love hot, humid conditions.  Heat and humidity raise ozone levels. Ozone is the culprit in air pollution. Humidity makes the air stagnant, trapping pollutants such as car exhaust, as well as pollen and mold spores.

Is there a cure for skin asthma?

There is no cure for skin asthma (atopic dermatitis), but children suffering from this disorder fortunately find that periods of remission (temporary recovery from the disease) grow longer and longer as they age. Only around 20 percent of children continue to have outbreaks past adolescence. For the majority, the body naturally controls breakouts until the respite of the flare.

Treatments available must instead focus on relieving rather than stopping the symptoms. Topical creams can soothe itching and a doctor may prescribe a mild corticosteroid cream. Lotions will also help relieve dryness and can lessen the symptoms.

The good news is that it is almost always confined to the childhood years and outbreaks will subside, unlike other conditions like gluten psoriasis or other ailments, which may require an entire lifestyle change throughout adulthood to control.

What is one important thing that you should know about skin asthma?

Many young children who get a severe skin rash go on to develop allergic rhinitis, allergic conjunctivitis and eventually pulmonary asthma. Doctors call this progression from skin asthma to breathing problems “the atopic march.”  

Researchers found that cells in damaged skin can secrete TSLP (thymic stromal lymphopoietin), a compound capable of eliciting a powerful immune response. And because the skin is so effective in secreting TSLP into the blood system, the substance travels throughout the body. This is some sort of an alarm system alerting the body that its protective barrier function has failed. This substance then activates an immune response that fights invaders. When it reaches the lungs, it triggers the hypersensitivity characteristic of pulmonary asthma.

This research outcome shows that skin can act as a signaling organ and drive allergic inflammation in the lung by releasing TSLP. This is a very important breakthrough, as it will address us on how to prevent dysfunctional skin from producing TSLP.

If that can be done, the link between skin asthma and pulmonary asthma could be broken.  The latest therapies are targeted towards maintenance of the skin barrier, replacement of healthy skin microorganisms, and biologic therapy.

Photo by wayhomestudio/www.freepik.com