Atopic dermatitis
Summary
Definition
History and exam
Key diagnostic factors
- pruritus
- xerosis (dry skin)
- sites of skin involvement
Other diagnostic factors
- erythema
- scaling
- vesicles
- papules
- keratosis pilaris
- excoriations
- lichenification
- hypopigmentation
Risk factors
- filaggrin gene mutation
- age <5 years
- family history of atopic dermatitis
- allergic rhinitis
- asthma
- active and passive exposure to smoke
- female sex
- African-American ethnicity
Diagnostic investigations
1st investigations to order
- clinical diagnosis
Investigations to consider
- IgE levels
- skin-prick testing
- oral food challenge
- trial elimination diet
- patch testing
- skin biopsy
Treatment algorithm
acute flare
chronic or relapsing disease (nonrefractory)
refractory chronic or relapsing disease
Contributors
Authors
Adelaide A. Hebert, MD
Professor & Director of Pediatric Dermatology
Clinical Specialist
Department of Dermatology and Pediatrics
University of Texas Health Sciences Center at Houston
Houston
TX
Disclosures
AAH serves on the board of the International Hyperhidrosis Society and the American Academy of Dermatology; consults for Pfizer, Galderma, LaRoche Posay, Arcutis, Incyte, Vyne, Varrica, Beiersdorf, Aslan, and Ortho Dermatologics; has undertaken or is undertaking contractual research for Pfizer, Galderma, Ortho Dermatologics, Aslan, Leo, Mayne, Arcutis, Incyte, Verrica, Novan, Brickell, and Almirall; is on the data safety monitoring boards for GSK, Regeneron, and Sanofi; and is on the speakers' bureaux for Pfizer, Almirall, and Galderma.
Kavina Patel, MD
Dermatology Clinical Research Fellow
Department of Dermatology
University of Texas Health Science Center at Houston
Houston
TX
Disclosures
KP declares that she has no competing interests.
Matthew Dallo, MD
Clinical Research Fellow
Department of Dermatology
University of Texas Health Science Center at Houston
Houston
TX
Disclosures
MD declares that he has no competing interests.
Eugenio G. Galindo, MD
Dermatology Clinical Research Fellow
UTHealth McGovern Medical School
Houston
TX
Disclosures
EGG declares that he has no competing interests.
Acknowledgements
Dr Adelaide A. Hebert, Dr Kavina Patel, Dr Matthew Dallo, and Dr Eugenio G. Galindo would like to gratefully acknowledge Dr Quoc-Bao D. Nguyen, Dr Mary D. DarConte, Dr Christina M. Gelbard, and Dr Daniel A. Grabella, previous contributors to this topic.
Disclosures
QNN, MDD, CMG, and DAG declare that they have no competing interests.
Peer reviewers
Amor Khachemoune, MD
Assistant Professor
New York University School of Medicine
NY
Disclosures
AK declares that he has no competing interests.
John English, MBBS, FRCP
Consultant Dermatologist
Department of Dermatology
Queen's Medical Centre
Nottingham University Hospitals
Nottingham
UK
Disclosures
JE declares that he has no competing interests.
Differentials
- Seborrheic dermatitis
- Irritant contact dermatitis
- Allergic contact dermatitis
More DifferentialsGuidelines
- Awareness of comorbidities associated with atopic dermatitis in adults
- Guideline for the systemic treatment of atopic eczema
More GuidelinesPatient leaflets
Eczema
More Patient leaflets
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