From the Guidelines
Atopic dermatitis is characterized by a chronic, pruritic inflammatory skin disease with a relapsing course, often presenting as a red, itchy, and inflamed rash that can appear anywhere on the body. The rash is typically dry, scaly, and may ooze or weep clear fluid when scratched, with areas of lichenification due to chronic scratching and inflammation 1. In infants, the rash often appears on the cheeks and scalp, while in children and adults, it tends to affect the flexural areas of the body, such as the inside of elbows, behind the knees, and hands. The appearance of the rash can vary depending on the person's age, skin tone, and severity of the condition, with darker skin tones potentially appearing as darker brown, purple, or grayish instead of red. The intense itching associated with atopic dermatitis can lead to a cycle of scratching and further skin damage, resulting in secondary bacterial infections characterized by increased redness, swelling, and yellow crusting. Some patients with atopic dermatitis may also have allergic contact dermatitis, which can manifest as eczematous lesions and should be considered as an alternative or concomitant diagnosis 1.
Key characteristics of the atopic dermatitis rash include:
- Dry, scaly patches that may ooze or weep clear fluid when scratched
- Lichenification due to chronic scratching and inflammation
- Variation in appearance depending on age, skin tone, and severity of the condition
- Potential for secondary bacterial infections
- Periodic flares triggered by factors such as dry skin, irritants, stress, allergens, and temperature changes.
It is essential to note that the diagnosis of atopic dermatitis and the distinction from other conditions, such as allergic contact dermatitis, require a detailed history, careful evaluation, and correlation of allergy test results to determine clinical relevance 1.
From the FDA Drug Label
Of the key signs of atopic dermatitis, erythema, infiltration/papulation, lichenification, and excoriations,
- Erythema
- Infiltration/papulation
- Lichenification
- Excoriations are the signs of atopic dermatitis. The atopic dermatitis rash description includes these signs. 2
From the Research
Atopic Dermatitis Rash Description
- Atopic dermatitis is a chronic relapsing and remitting inflammatory skin disease characterized by intensely pruritic skin lesions 3
- The rash is caused by a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors that disrupt the epidermis 3
- Repeated scratching triggers a self-perpetuating itch-scratch cycle, which can have a significant impact on the patient's quality of life 3
Characteristics of the Rash
- The rash can appear anywhere on the body, but it often affects the face, hands, feet, and inside the elbows and behind the knees 3
- The lesions can be red, dry, and scaly, and may crust or ooze 3
- The rash can be accompanied by other symptoms such as itching, burning, and stinging 3
Treatment and Management
- Topical corticosteroids are the first-line treatment for atopic dermatitis flare-ups 3, 4
- Topical calcineurin inhibitors, such as pimecrolimus and tacrolimus, can be used in conjunction with topical corticosteroids as first-line treatment 3, 4
- Maintenance therapy consists of liberal use of emollients and daily bathing with soap-free cleansers 3
- Systemic corticosteroids should be avoided in elderly patients due to questionable efficacy and increased adverse events 5, 6