Skip to main content

Atopic Dermatitis: Overview

  • Chapter
  • First Online:
Book cover Allergies and Adolescents

Abstract

Atopic dermatitis (AD) is a chronic, relapsing, and pruritic disease that classically develops in early childhood. There appears to be many contributing factors in the development of this disease including both genetic and environmental interactions, which ultimately lead to impaired epidermal barrier function and immune dysregulation. AD has a variable presentation depending upon age, and the diagnosis is based on clinical history and diagnostic characteristics. When making the diagnosis of AD, it is important to exclude conditions that present with similar erythematous, scaling, and pruritic rashes. The mainstay of treatment focuses on the maintenance of the skin barrier through pharmacological and/or non-pharmacological means. In this chapter, we will review important factors in making the diagnosis and treatment options. We will also discuss common pitfalls that occur in the management of this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–51.

    Article  PubMed  Google Scholar 

  2. Bieber T. How to define atopic dermatitis? Dermatol Clin. 2017;35(3):275–81.

    Article  CAS  PubMed  Google Scholar 

  3. Chong M, Fonacier L. Treatment of eczema: corticosteroids and beyond. Clin Rev Allergy Immunol. 2016;51(3):249–62.

    Article  CAS  PubMed  Google Scholar 

  4. Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25(1):1–6.

    Article  PubMed  Google Scholar 

  5. Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology, and treatment. Immunol Allergy Clin N Am. 2015;35(1):161–83.

    Article  Google Scholar 

  6. Irvine AD, McLean WHI, Leung DYM. Filaggrin mutations associated with skin and allergic diseases. N Engl J Med. 2011;365(14):1315–27.

    Article  CAS  PubMed  Google Scholar 

  7. Ou L-S, Goleva E, Hall C, Leung DYM. T regulatory cells in atopic dermatitis and subversion of their activity by superantigens. J Allergy Clin Immunol. 2004;113(4):756–63.

    Article  CAS  PubMed  Google Scholar 

  8. Siegfried EC, Hebert AA. Diagnosis of atopic dermatitis: mimics, overlaps, and complications. J Clin Med. 2015;4(5):884–917.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. van Zuuren EJ, Fedorowicz Z, Christensen R, Lavrijsen A, Arents BW. Emollients and moisturisers for eczema. Cochrane Database Syst Rev. 2017;2:CD012119.

    PubMed  Google Scholar 

  10. Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116–32.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nicol NH, Boguniewicz M, Strand M, Klinnert MD. Wet wrap therapy in children with moderate to severe atopic dermatitis in a multidisciplinary treatment program. J Allergy Clin Immunol Pract. 2014;2(4):400–6.

    Article  PubMed  Google Scholar 

  12. Portnoy J, Miller JD, Williams PB, Chew GL, Miller JD, Zaitoun F, et al. Environmental assessment and exposure control of dust mites: a practice parameter. Ann Allergy Asthma Immunol. 2013;111(6):465–507.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013;131(2):295–9.e1–27.

    Article  PubMed  Google Scholar 

  14. Crall CS, Rork JF, Delano S, Huang JT. Phototherapy in children: considerations and indications. Clin Dermatol. 2016;34(5):633–9.

    Article  PubMed  Google Scholar 

  15. Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71:327–49.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tollefson MM, Bruckner AL. Section on dermatology. Atopic dermatitis: skin-directed management. Pediatrics. 2014;134(6):e1735–44.

    Article  PubMed  Google Scholar 

  17. Arkwright PD, Motala C, Subramanian H, Spergel J, Schneider LC, Wollenberg A, et al. Management of difficult-to-treat atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1(2):142–51.

    Article  PubMed  Google Scholar 

  18. Broeders JA, Ahmed Ali U, Fischer G. Systematic review and meta-analysis of randomized clinical trials (RCTs) comparing topical calcineurin inhibitors with topical corticosteroids for atopic dermatitis: a 15-year experience. J Am Acad Dermatol. 2016;75(2):410–3.

    Article  CAS  PubMed  Google Scholar 

  19. Friedman B-C, Goldman RD. Anti-staphylococcal treatment in dermatitis. Can Fam Physician. 2011;57(6):669–71.

    PubMed  PubMed Central  Google Scholar 

  20. Chang Y-S, Chou Y-T, Lee J-H, Lee P-L, Dai Y-S, Sun C, et al. Atopic dermatitis, melatonin, and sleep disturbance. Pediatrics. 2014;134(2):e397–405.

    Article  PubMed  Google Scholar 

  21. Fishbein AB, Vitaterna O, Haugh IM, Bavishi AA, Zee PC, Turek FW, et al. Nocturnal eczema: review of sleep and circadian rhythms in children with atopic dermatitis and future research directions. J Allergy Clin Immunol. 2015;136(5):1170–7.

    Article  PubMed  Google Scholar 

  22. Buddenkotte J, Steinhoff M. Pathophysiology and therapy of pruritus in allergic and atopic diseases. Allergy. 2010;65(7):805–21.

    Article  CAS  PubMed  Google Scholar 

  23. Blauvelt A, de Bruin-Weller M, Gooderham M, Cather JC, Weisman J, Pariser D, et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet. 2017;389(10086):2287–303.

    Article  CAS  PubMed  Google Scholar 

  24. Sokolova A, Smith SD. Factors contributing to poor treatment outcomes in childhood atopic dermatitis. Australas J Dermatol. 2015;56(4):252–7.

    Article  PubMed  Google Scholar 

  25. Sidbury R, Tom WL, Bergman JN, Cooper KD, Silverman RA, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014;71(6):1218–33.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kojima R, Fujiwara T, Matsuda A, Narita M, Matsubara O, Nonoyama S, et al. Factors associated with steroid phobia in caregivers of children with atopic dermatitis. Pediatr Dermatol. 2013;30(1):29–35.

    Article  PubMed  Google Scholar 

  27. Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol. 2014;134(5):1016–43.

    Article  PubMed  Google Scholar 

  28. Chang A, Robison R, Cai M, Singh AM. Natural history of food-triggered atopic dermatitis and development of immediate reactions in children. J Allergy Clin Immunol Pract. 2016;4(2):229–36.e1.

    Article  PubMed  Google Scholar 

  29. Togias A, Cooper SF, Acebal ML, Assa’ad A, Baker JR, Beck LA, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. J Allergy Clin Immunol. 2017;139(1):29–44.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rekha Raveendran MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Prince, B.T., Raveendran, R. (2018). Atopic Dermatitis: Overview. In: Stukus, D. (eds) Allergies and Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-319-77485-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77485-5_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77484-8

  • Online ISBN: 978-3-319-77485-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics