Difference between revisions of "Atopic dermatitis"

(Sources)
(Clinical features)
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*Atopic personal or family hx, worse in winter, dry weather
 
*Atopic personal or family hx, worse in winter, dry weather
 
*Erythema, crusts, fissures, pruritis, excoriations, lichenification
 
*Erythema, crusts, fissures, pruritis, excoriations, lichenification
*Infantile form - blisters, crusts, exfoliations
+
 
 +
===Infantile===
 +
*blisters, crusts, exfoliations
 
**Face, scalp, extremities
 
**Face, scalp, extremities
 
**1st few months of life, resolving by age 2
 
**1st few months of life, resolving by age 2
 
**Differentiate from impetigo (which may occur alongside)
 
**Differentiate from impetigo (which may occur alongside)
*Adults
+
 
 +
===Adults===
 
**Dryness, thickening in AC and popliteal fossa, neck
 
**Dryness, thickening in AC and popliteal fossa, neck
  

Revision as of 07:31, 9 June 2016

Background

  • Must distinguish from Seborrheic Dermatitis
    • Occurs between 2-6mo (somewhat later than seborrheic dermatitis)
    • Pruritic (may manifest as fussiness) vs seborrheic (not pruritic)
Atopic dermatitits.jpg

Clinical features

  • Atopic personal or family hx, worse in winter, dry weather
  • Erythema, crusts, fissures, pruritis, excoriations, lichenification

Infantile

  • blisters, crusts, exfoliations
    • Face, scalp, extremities
    • 1st few months of life, resolving by age 2
    • Differentiate from impetigo (which may occur alongside)

Adults

    • Dryness, thickening in AC and popliteal fossa, neck

Diagnosis

  • Dry skin, erythematous papular lesions
  • Face most commonly involved; nose and diaper areas spared

Differential Diagnosis

Neonatal Rashes

Complications

Treatment

  • Identify and eliminate triggers
  • Reduce drying of skin
  • Liberal application of emollients (vaseline)
  • Triamcinolone, hydrocortisone, or betamethasone
  • Avoid fluoridinated steroids to the face
  • Consider doxepin for recalcitrant pruritis[1][2]
    • 25-50 mg PO qhs
    • Or topical doxepin cream 5% QID

See Also

References

  1. Hercogova J. Topical anti-itch therapy. Dermatol Ther 18(4):341-3 (2005 Jul-Aug).
  2. Drake L, Cohen L, Gillies R, et al. Pharmakinetics of doxepin in subjects with pruritic atopic dermatitis. J Am Acad Dermatol 41(2):209-14 (1999 Aug).