Atopic Dermatitis

A chronic, immune-mediated, pruritic, inflammatory skin condition seen in atopic individuals.
Marked by alternating periods of remission and flare-ups.
A result of complex interplay between environmental, immunologic, genetic and pharmacologic factors.
Aggravated by infection, psychological stress, seasonal changes, irritants, and allergens.

Book an Appointment View Speciality

Symptoms

Clinical features

Age of onset typically during infancy (2 to 6 months); but may start at any age.
Clinical features vary at different phases of life; and comprise:
Itching
Macular erythema, papules or papulo-vesicles
Eczematous areas with crusting
Lichenification and excoriation
Dryness of the skin
Cutaneous reactivity
Secondary infection

Complications

Causes

Mutation in FILAGGRIN gene responsible for holding skin moisture

Prevention

Moisturize your skin atleast twice a day
Try to identify and avoid triggers that worsen the condition
Take shorter baths
Tak e a bleach bath
Use only gentle soaps
Dry yourself carefully

Risk Factors

How is it diagnosed?

Hannifin and Rajki Criteria
Diagnostic criteria: Major features
- Pruritus.
- Typical morphology and distribution - Facial and extensor involvement in infants and children, flexural lichenification in adults.
- Chronic or relapsing dermatitis.
- Personal or family history of atopy (atopic dermatitis; asthma; allergic rhinitis).

Diagnostic criteria: Minor features

Xerosis
Ichthyosis, palmar hyperlinearity, or keratosis pilaris
Immediate (type 1) skin-test reactivity
Raised serum IgE
Early age of onset
Tendency toward cutaneous infections (especially S aureus and herpes simplex) or impaired cell-mediated immunity
Tendency toward non-specific hand or foot dermatitis
Nipple eczema
Cheilitis , Recurrent conjunctivitis
Dennie-Morgan- infraorbital fold
Keratoconus
Anterior subcapsular cataracts
Orbital darkening
Facial pallor or facial erythema
Pityriasis alba
Anterior neck folds
Itch when sweating
Intolerance to wool and lipid solvents
Perifollicular accentuation
Food intolerance
Course influenced by environmental or emotional factors
White dermographism or delayed blanch

How is it treated?

Identify and control ‘flare factors’

Bathing; Emollients; Humectants
Corticosteroids
Calcineurin inhibitors : Pimecrolimus; tacrolimus
Icthamol and tar

Antihistamines
Sedative antihistamines preferred
Promethazine; trimeperazine; hydroxyzine
Antibiotics
Systemic steriods (in severe cases)

Intensive topical therapy- step up to potent steroid
Wet wrap technique
Allergy management
- Food
- Inhalants
- Contact allergy

Phototherapy
Oral immunosuppresants
Allergy management
- Cyclosporine
- Azathriopine
- Thymopentine
- α- Interferon
- Desensitization

Consult with experienced Doctors

JNU is home to some of the most eminent doctors in the world, most of whom are pioneers in their respective arenas and are renowned for developing innovative and revolutionary procedures