Difference between revisions of "Atopic dermatitis"

(Distinguish from Seborrheic Dermatitis)
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**Face most commonly involved; nose and diaper areas spared
**Face most commonly involved; nose and diaper areas spared
===Distinguish from [[Seborrheic Dermatitis]]===
===Neonatal [[atopic dermatitis]] vs. [[Neonatal seborrhoeic dermatitis|seborrhoeic dermatitis]]===
*Occurs between 2-6mo (somewhat later than seborrheic dermatitis)
*Pruritic (may manifest as fussiness) vs seborrheic (not pruritic)
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Revision as of 01:40, 15 August 2016


  • Also know as atopic eczema
  • A chronic type of inflammatory skin disease affecting many children and adults
  • Occasionally accompanied by asthma and/or hay fever. Patients develop a cutaneous hyperreactivity to environmental triggers.
  • Cause is not known, but believed to be due to an interaction between susceptibility genes, the environment, defective skin barrier function, and immunologic responses.

Clinical Features

Atopic dermatitits.jpg
  • Atopic personal or family history, worse in winter, dry weather
  • Erythema, crusts, fissures, pruritis, excoriations, lichenification


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


  • Dryness, thickening in AC and popliteal fossa, neck

Differential Diagnosis

Neonatal Rashes


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

Neonatal atopic dermatitis vs. seborrhoeic dermatitis

Category Neonatal atopic dermatitis Neonatal seborrhoeic dermatitis
Presentation 1-2 months 2-6 months
Puritic (fussiness) Yes No


  • 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]
    • 25-50mg PO qhs
    • Or topical doxepin cream 5% QID


  • Outpatient


See Also


  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).