Exposure to environmental irritants can worsen symptoms, as can
dryness of the skin, exposure to water, temperature changes, and
- intense itching
- blisters (vesicle formation) with oozing and crusting
- skin redness or inflammation around the blisters
- rash, in child under 2 years old
- skin lesions begin on the cheeks in infants
- may progress to the scalp, arms, trunk, and legs
- dry, leathery skin areas (lichenification)
- more or less pigment than their normal skin tone (see skin,
abnormally dark or light)
- located commonly in the inner elbow or behind the knee
- may spread to the neck, hands, feet, eyelids, or behind the
- raw areas (excoriation) of the skin--from scratching
- ear discharges/bleeding
Signs And Tests
Diagnosis is primarily based on the appearance of the skin and
on personal and family history. The health care provider should
examine the lesions to rule out other possible causes. A skin
lesion biopsy may be performed, but is not always required to
make the diagnosis.
This disease may also alter the results of an eosinophil count
- absolute test.
Consult your health care provider for diagnosis of atopic dermatitis,
because it can be difficult to differentiate from other skin disorders.
Treatment should be guided by the health care provider. The goal
of treatment is reduction of symptoms.
Treatment may vary depending on the appearance (stage) of the
lesions--acute weeping lesions, dry scaly lesions, or chronic
dry thickened lesions are each treated differently.
Infantile eczema usually becomes milder with age and often disappears
after age 3 or 4. Atopic dermatitis usually responds to home treatment.
Treatment is designed around the chronic nature of the disease.
Anything that aggravates the symptoms should be avoided whenever
possible, including any food allergens and environmental irritants
such as wool and lanolin. Dry skin often makes the condition worse,
so bathing and the use of soaps may be reduced. Temperature changes
and stress may cause sweating and changes in the blood vessels
of the skin, also aggravating the condition.
If avoidance of irritants does not reduce symptoms, treatment
applied to a localized area of the skin (topical) may be indicated.
Topical treatment of weeping lesions may include soothing lotions,
mild soaps, or wet dressings. Mild antipruritic lotions or topical
steroids (see corticosteroids-topical-low potency) may soothe
less acute or healing areas, or dry scaly lesions. Chronic thickened
areas may be treated with ointments or creams that contain tar
compounds, topical steroids (see corticosteroids-topical-medium
to very high potency), ingredients that lubricate or soften the
skin, or other ingredients. Systemic corticosteroids may be prescribed
to reduce inflammation in some severe cases.
Atopic dermatitis is a chronic condition, but it may be controlled
with treatment and avoidance of irritants.
Calling Your Health Care Provider
- Secondary bacterial infections of the skin
- Permanent scar formation
Call for an appointment or make
if atopic dermatitis does not respond to avoidance
of allergens, if symptoms worsen or treatment is ineffective, or
if signs of infection (such as fever, redness, pain) occur.
No known prevention. The condition tends to run in families. Control
of stress and emotional conditions (nervousness, anxiety, depression,
etc.) can be beneficial in some cases.