Atopic Dermatitis 

Definition: Atopic Dermatitis (AD) is a chronic inflammatory skin disorder marked by scaly, erythematous, and itchy skin lesions that are frequently seen in the body’s flexural surfaces (1).

Etiology: Atopic dermatitis can often present as part of an atopic/allergic triad presenting with asthma and allergic rhinitis (1). Most individuals with AD will have a personal or family history and/or an increased production of immunoglobulin (Ig) E antibodies (4).

Epidemiology: The onset is typically before the age of two with a reported 10% of cases presenting after the age of five (1). The prevalence in children is approximately 20% and in adults it ranges from 7% to 14% (2).

Signs: Scaly, erythematous plaques usually accompanied by lichenification (4). 

Symptoms: Patients present with dry skin and an itchy rash which can lead to infection and substantial reduction of quality of life (2).

Differentials: Candidiasis, conditions that cause generalized pruritus, contact dermatitis, dermatitis herpetiformis, impetigo, lichen simplex chronicus, nummular eczema, psoriasis, scabies, seborrheic dermatitis, urticaria and xerosis (1).

Diagnosis: Diagnosis is based on a comprehensive history and physical exam (1). If needed a biopsy or patch can be performed (3).

Treatment: The goal of treatment is to relieve symptoms and increase the period in between flare-ups (1). Emollients are recommended as treatment with topical corticosteroids being first line treatment for flare-ups of atopic dermatitis (1).

References: (AMA)

1.      1. Berke R, Singh A, Guralnick M. Atopic dermatitis: An overview. American Family Physician. July 1, 2012. Accessed August 18, 2024. https://www.aafp.org/pubs/afp/issues/2012/0701/p35.html#clinical-presentation-and-differential-diagnosis.

2.     Bylund S, Kobyletzki L, Svalstedt M, Svensson. Prevalence and incidence of atopic dermatitis: A systematic review. Acta Dermato Venereologica. 2020;100(12). doi:10.2340/00015555-3510 

3.     Sidbury R, Alikhan A, Bercovitch L, et al. Guidelines of care for the management of atopic dermatitis in adults with topical therapies. Journal of the American Academy of Dermatology. 2023;89(1). doi:10.1016/j.jaad.2022.12.029

4.     Saeki H, Ohya Y, Furuta J, et al. English version of Clinical Practice Guidelines for the management of atopic dermatitis 2021. The Journal of Dermatology. 2022;49(10). doi:10.1111/1346-8138.16527