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Atopic dermatitis


Definition:

Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes.

Other forms of eczema include:

Alternative Names:

Infantile eczema; Dermatitis - atopic; Eczema

Signs and tests:

The health care provider will give you an exam and look at your skin. A physical exam will be done. You may need a skin biopsy  to confirm the diagnosis or rule out other causes of dry, itchy skin.

Diagnosis is based on the:

  • How the skin looks
  • Personal and family history

Allergy skin testing may be helpful for people with:

  • Hard-to-treat atopic dermatitis
  • Other allergy symptoms
  • Skin rashes that form only on certain areas of the body after exposure to a specific chemical
Expectations (prognosis):

Atopic dermatitis is a long-term condition. You can control it with treatment, by avoiding irritants, and by keeping the skin well-moisturized.

In children, the condition often starts to go away around age 5 - 6, but flare-ups will often occur. In adults, the problem is generally a long-term or returning condition.

Atopic dermatitis may be harder to control if it:

  • Begins at an early age
  • Involves a large amount of the body
  • Occurs along with allergic rhinitis and asthma
  • Occurs in someone with a family history of eczema
Complications:
  • Infections of the skin caused by bacteria, fungi, or viruses
  • Permanent scars
  • Side effects from long-term use of medicines to control eczema
Calling your health care provider:

Call  your health care provider if:

  • Atopic dermatitis does not get better with home care 
  • Symptoms get worse or treatment does not work
  • You have signs of infection (such as fever, redness, or pain)
Prevention:

Children who are breast-fed until age 4 months are less likely to get atopic dermatitis.

If a child is not breast-fed, using a formula that contains processed cow milk protein (called partially hydrolyzed formula) may cut down on the chances of developing atopic dermatitis.

References:

Atopic Dearmatitis, Eczema, and Noninfectious Immunodeficiency Disorders. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 5.

Greer FR, Sicherer SH, Burks, W and the Committee on Nutrition and Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121:183-191.

Lewis-Jones S, Mugglestone MA; Guideline Development Group. Management of atopic eczema in children aged up to 12 years: summary of NICE guidance. BMJ. 2007;335:1263-1264.

Ascroft DM, Chen LC, Garside R, Stein K, Williams HC. Topical pimecrolimus for eczema. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005500.

Bath-Hextall FJ, Delamere FM, Williams HC. Dietary exclusions for established atopic eczema. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005203.


Review Date: 11/20/2012
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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