Atopic Dermatitis

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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Atopic dermatitis is a type of eczema.
• The skin sensitivity of this disease may be inherited and genetically determined.
• The patient's skin may be "super sensitive" to many irritants.
• Dry scaly patches develop in a characteristic distribution.
• Itching varies but may be intense and scratching hard to resist.
• Scratching can cause skin thickening and darkening and lead to further complications, including bacterial infection.
• Extremely dry skin can break down and ooze or weep.
• If the itch can be controlled, the rash (which is aggravated by vigorous scratching) may be more readily contained.
• Treatment of atopic dermatitis is centered around rehydrating the skin with rich moisturizers like Vaseline and cautious use of topical steroids to reduce inflammation and itching.
• Oral antihistamines are often necessary to break the "itch-scratch" cycle.
• Since secondary infections can aggravate the rash, topical or oral antibiotics may also be occasionally indicated.

Atopic dermatitis is a very common, often long-lasting skin disease that affects a large percentage of the world's population. It is a special type of allergic hypersensitivity that includes a triad of conditions that includes asthma, inhalant allergies (hay fever), and a chronic dermatitis (eczema). There is a known hereditary component of the disease, and it is more common in affected families. Criteria that enable your doctor to diagnose it include the typical appearance and distribution of the rash in a patient with a personal or family history of asthma and/or hay fever.

The term atopic is from the Greek meaning "strange." The term dermatitis means inflammation of the skin.

In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, vesicle formation (minute blisters), cracking, weeping, crusting, and scaling. This type of eruption is termed eczematous. In addition, dry skin is a very common complaint in almost all those afflicted with atopic dermatitis.

Although atopic dermatitis can occur in any age, most often it affects infants and young children. Occasionally, it may persist into adulthood or may actually appear at that time. Some patients tend to have a protracted course with various ups and downs. In most cases, there are periods of time when the disease is worse, called exacerbations or flares, which are followed by periods when the skin improves or clears up entirely, called remissions. Most children with atopic dermatitis enter into a permanent remission of the disease when they get older, although their skin may remain somewhat dry and easily irritated.

Multiple factors can trigger or worsen atopic dermatitis, including low humidity, seasonal allergies, exposure to harsh soaps and detergents, and cold weather. Environmental factors can activate symptoms of atopic dermatitis at any time in the lives of individuals who have inherited the atopic disease trait.