Atopic Dermatitis (Eczema)
Atopic dermatitis is a chronic, relapsing, inflammatory skin condition characterized by defective skin barrier function (often due to filaggrin mutation) and immune dysregulation. It is part of the “atopic triad” (atopic dermatitis, asthma, allergic rhinitis).
Age-Related Distribution
| Age Group | Clinical Pattern |
|---|---|
| Infants | Extensor surfaces, face, and scalp; “sparing the diaper area.” |
| Children/Adults | Flexural surfaces (antecubital and popliteal fossae), neck, wrists, and ankles. |
Management Pillars
- Emollients: The cornerstone of therapy; restores the skin barrier.
- Topical Anti-inflammatories: Topical corticosteroids (for flares) or topical calcineurin inhibitors (tacrolimus/pimecrolimus).
- Trigger Avoidance: Identifying and minimizing irritants (soaps, detergents, environmental allergens).
High-Yield Exam Pearl:
- Complications: Patients are highly susceptible to secondary infections, specifically Staph aureus (impetiginization) and Eczema Herpeticum (disseminated HSV infection on eczematous skin).
- The Itch-Scratch Cycle: The intense pruritus leads to scratching, which further damages the barrier and increases inflammation, perpetuating the cycle.