Atopic Dermatitis

  • Medical Author:
    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    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.

Quick GuideEczema (Atopic Dermatitis) Causes, Symptoms, Treatment

Eczema (Atopic Dermatitis) Causes, Symptoms, Treatment

What specialists treat atopic dermatitis?

Pediatricians, allergists, and dermatologists care for most patients with atopic dermatitis.

How do physicians diagnose atopic dermatitis?

The diagnosis is made on the physical examination and visual inspection of the skin. The personal history of inhalant allergies and family history will often support the diagnosis. Although itching is necessary but not sufficient to diagnose atopic dermatitis, consideration of other itchy eruptions is often necessary.

A skin biopsy (a sample of a small piece of skin that is sent to the lab for examination under the microscope) is rarely helpful to establish the diagnosis. Many patients with severe atopic disease may have elevated numbers of a certain type of white blood cells (eosinophils) and/or elevated serum IgE level. These tests can support the diagnosis of atopic dermatitis. Additionally, skin swab (long cotton tip applicator or Q-tip) samples may be sent to the lab to exclude staphylococcal infections of the skin, which may complicate atopic dermatitis.

Skin scratch/prick tests (which involve scratching or pricking the skin with a needle that contains a small amount of a suspected allergen) and blood tests for airborne allergens generally are not as useful in diagnosing atopic dermatitis. Positive skin scratch/prick test results are difficult to interpret in people with atopic dermatitis and are often inaccurate.

Major and minor features of atopic dermatitis

Major features

  • Itching
  • Characteristic rash in locations typical of the disease (arm folds and behind knees)
  • Chronic or repeatedly occurring symptoms
  • Personal or family history of atopic disorders (eczema, hay fever, asthma)

Some minor features

  • Early age of onset
  • Dry, rough skin
  • High levels of immunoglobulin E (IgE), an antibody, in the blood
  • Ichthyosis
  • Hyper linear palms
  • Keratosis pilaris
  • Hand or foot dermatitis
  • Cheilitis (dry or irritated lips)
  • Nipple eczema
  • Susceptibility to skin infection
  • Positive allergy skin tests
Medically Reviewed by a Doctor on 12/21/2016

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