From the Guidelines
Atopic dermatitis (eczema) is a chronic, pruritic inflammatory skin disease characterized by a relapsing course, often associated with a personal or family history of allergic rhinitis and asthma. According to the most recent guidelines, atopic dermatitis is a condition that occurs most frequently in children, but also affects many adults 1. The diagnosis of atopic dermatitis is usually made clinically, but alternative or concomitant causes of dermatitis, such as allergic contact dermatitis or irritant contact dermatitis, should also be considered and evaluated via comprehensive history taking and physical exam 1.
Some key characteristics of atopic dermatitis include:
- A chronic and relapsing course
- Pruritic inflammatory skin disease
- Often associated with a personal or family history of allergic rhinitis and asthma
- Can occur in both children and adults
- Diagnosis is usually made clinically, but may require additional tests such as biopsy or patch testing if warranted 1
It's worth noting that while another study discussed the management of atopic dermatitis, including the use of systemic therapy for moderate-to-severe cases 1, the definition and characterization of the condition are most accurately described in the 2023 guidelines 1.
The clinical presentation of atopic dermatitis can vary, but it often appears as dry, scaly patches that may become crusty or ooze fluid when scratched. Managing atopic dermatitis typically involves keeping the skin moisturized, avoiding known triggers, and using topical corticosteroids or other prescription medications as needed 1.
From the Research
Definition and Characteristics of Atopic Dermatitis
- Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory skin condition characterized by relapsing pruritic and dry, scaly lesions 2, 3, 4, 5, 6.
- It is caused by a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors that disrupt the epidermis, causing intensely pruritic skin lesions 3, 4.
- The condition affects 10% to 20% of children in the United States and significantly affects the quality of life of patients and their families 2.
Prevalence and Impact
- Atopic dermatitis affects one in 10 people in their lifetime 3.
- It is the leading non-fatal health burden attributable to skin diseases, inflicting a substantial psychosocial burden on patients and their relatives, and increasing the risk of food allergy, asthma, allergic rhinitis, other immune-mediated inflammatory diseases, and mental health disorders 4.
- The condition has increased in prevalence in recent decades and now affects up to 25% of school-aged children in the developed world and up to 10% of adults 6.
Pathogenesis and Prevention
- Defects of the epidermal barrier are central to the development of atopic dermatitis 4.
- Restoration of epidermal barrier function is best achieved through the use of emollients, and topical corticosteroids are still the first-line therapy for acute flares 4, 6.
- Emerging concepts and clinical evidence address the pathogenesis and prevention of AD, including skin barrier enhancement strategies, probiotics, prebiotics, and synbiotics, as well as antimicrobial exposure, vitamin D, and omega fatty acid supplementation 5.