Vulvar Disease pp 143-148 | Cite as

Atopic Dermatitis

  • Tanja Bohl


Atopic dermatitis (AD) and eczema are often used interchangeably. AD is a common, pruritic, chronic inflammatory dermatosis characterized clinically by relapsing episodes of flares of intensely pruritic, inflammatory skin lesions. AD is predominantly mediated by T-helper cells with T-helper 2 (Th2) primarily in acute AD and T-helper 1 (Th-1) in chronic AD. A dysfunctional epidermal barrier function is present. A genetic component to the aetiology of AD is supported by the familial clustering. The principles of management of vulvar AD are the same in all vulvar dermatoses: remove any trigger factors, identify and treat infections and apply bland, non-fragranced emollients/moisturizers frequently to prevent transepidermal water loss (TEWL). Liquid paraffin 50% may be helpful. Control of pruritus is essential for patient relief and to reduce trauma due to scratching which also is a trigger. Mild to moderate corticosteroids are often sufficient to establish control. For maintenance use weaker corticosteroid preparations, pimecrolimus 1% or tacrolimus 0.01%.


  1. 1.
    Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980;92:44–7.Google Scholar
  2. 2.
    Williams HC, Burney PG, Pembroke AC, Hay RJ. The U.K. working Party’s diagnostic criteria for atopic dermatitis. III. Independent hospital validation. Br J Dermatol. 1994;131(3):406–16.CrossRefGoogle Scholar
  3. 3.
    Samochocki Z, Dejewska J. A comparison of criteria for diagnosis of atopic dermatitis in children. World J Pediatr. 2012;8(4):355–8. Epub 2012 Nov 15.CrossRefPubMedGoogle Scholar
  4. 4.
    Vakharia PP, Chopra R, Silverberg JI. Systematic review of diagnostic criteria used in atopic dermatitis randomized controlled trials. Am J Clin Dermatol. 2017;19(1):15–22. Scholar
  5. 5.
    Silverberg JI, Thyssen JP, Paller AS, Drucker AM, et al. What’s in a name? Atopic dermatitis or atopic eczema, but not eczema alone. Allergy. 2017;72(12):2026–30. Scholar
  6. 6.
    Malik K, Heitmiller KD, Czarnowicki T. An update on the pathophysiology of atopic dermatitis. Dermatol Clin. 2017;35(3):317–26. Scholar
  7. 7.
    Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109–22. Epub 2015 Sep 13. (Review).CrossRefPubMedGoogle Scholar
  8. 8.
    Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(suppl 1):8–16.CrossRefGoogle Scholar
  9. 9.
    Rerknimitr P, Otsuka A, Nakashima C, Kabashima K. The etiopathogenesis of atopic dermatitis: barrier disruption, immunological derangement, and pruritus. Inflamm Regen. 2017;37:14. Published online 2017 Jun 5. Scholar
  10. 10.
    Farage MA, Warren R. Emollients on the genital area. Curr Probl Dermatol. 2011;40:101–6. Epub 2011 Feb 10.CrossRefPubMedGoogle Scholar
  11. 11.
    Silverberg NB. Typical and atypical clinical appearance of atopic dermatitis. Clin Dermatol. 2017;35(4):354–9. Epub 2017 Mar 24. (Review).CrossRefPubMedGoogle Scholar
  12. 12.
    Han H, Roan F, Ziegler SF. The atopic march: current insights into skin barrier dysfunction and epithelial cell-derived cytokines. Immunol Rev. 2017;278(1):116–30. (Review).CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Brunner PM, Silverberg JI, Guttman-Yassky E, Paller AS, Kabashima K, Amagai M, Luger TA, Deleuran M, Werfel T, Eyerich K, Stingl G. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Investig Dermatol. 2017;137:18–25. (Review).CrossRefGoogle Scholar
  14. 14.
    Hänel KH, Cornelissen C, Lüscher B, Baron JM. Cytokines and the skin barrier. Int J Mol Sci. 2013;14:6720–45. (Review).CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Brandt EB, Sivaprasad U. Th2 cytokines and atopic dermatitis. J Clin Cell Immunol. 2011;2(3):110. (Review).CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bantz SK, Zhu Z, Tao Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2):202. (Review).CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Bitschar K, Wolz C, Krismer B, Peschel A, Schittek B. Keratinocytes as sensors and central players in the immune defense against Staphylococcus aureus in the skin. J Dermatol Sci. 2017;87(3):215–20pii: S0923-1811(17)30707-7. Scholar
  18. 18.
    Dybboe R, Bandier J, Skov L, Engstrand L, Johansen JD. The role of the skin microbiome in atopic dermatitis: a systematic review. Br J Dermatol. 2017;177(5):1272–8. Scholar

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Tanja Bohl
    • 1
  1. 1.Jean Hailes for Women’s HealthClaytonAustralia

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