Atopic dermatitis (eczema)

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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186 Atopic dermatitis (eczema)

Instruction

Look at this patient’s skin.

Salient features

History

• Pruritus: this an important symptom because it affects the quality of life

• Tell the examiner that you would like to know whether there is a personal or family history of atopy (asthma, allergic rhinitis, atopic dermatitis) or food allergy.

Examination

• Scratch marks

• Hyperpigmented or hypopigmented lichenified lesions in flexures (including face, neck, upper trunk, wrists, hand, in the antecubital and popliteal folds) (Fig. 186.1).

image

Fig. 186.1 Flexural atopic dermatitis.

(With permission from Kumar, Clark 2005.)

Diagnosis

This patient has atopic dermatitis (lesion), which is caused by atopy as supported by a history of asthma (aetiology); it is causing the patient severe itching (functional status).

Questions

What are the stages of atopic dermatitis?

There are three age-related stages, which are separated by remission.

Infantile stage (up to 2 years of age). Red, scaly, itchy crusted rash on both cheeks and extensors of the extremities. The napkin area is generally spared. Eczema of the scalp may also be seen

Childhood stage (2–12 years).

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