Management Of Atopic Dermatitis: Diagnosis And Assessment Of Atopic Dermatitis

Publication Date: December 2, 2013
Last Updated: March 14, 2022

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DIAGNOSIS

Patients with presumed atopic dermatitis should have their diagnosis based on the criteria summarized in Box 1. On occasion, skin biopsy specimens or other tests (such as serum immunoglobulin E, potassium hydroxide preparation, patch testing, and/or genetic testing) may be helpful to rule out other or associated skin conditions. (C)
Box 1. Features to be considered in the diagnosis of patients with atopic dermatitis
ESSENTIAL FEATURES—Must be present:
d Pruritus
d Eczema (acute, subacute, chronic)
  1. Typical morphology and age-specific patterns*
  2. Chronic or relapsing history
*Patterns include:
  1. Facial, neck, and extensor involvement in infants and children
  2. Current or previous flexural lesions in any age group
  3. Sparing of the groin and axillary regions
IMPORTANT FEATURES—Seen in most cases, adding support to the diagnosis:
d Early age of onset
d Atopy
  1. Personal and/or family history
  2. Immunoglobulin E reactivity
d Xerosis
ASSOCIATED FEATURES—These clinical associations help to suggest the diagnosis of atopic dermatitis but are too nonspecific to be used for defining or detecting atopic dermatitis for research and epidemiologic studies:
d Atypical vascular responses (eg, facial pallor, white dermographism, delayed blanch response)
d Keratosis pilaris/pityriasis alba/hyperlinear palms/ichthyosis
d Ocular/periorbital changes
d Other regional findings (eg, perioral changes/periauricular lesions)
d Perifollicular accentuation/lichenification/prurigo lesions
EXCLUSIONARY CONDITIONS—It should be noted that a diagnosis of atopic dermatitis depends on excluding conditions, such as:
d Scabies
d Seborrheic dermatitis
d Contact dermatitis (irritant or allergic)
d Ichthyoses
d Cutaneous T-cell lymphoma
d Psoriasis
d Photosensitivity dermatoses
d Immune deficiency diseases
d Erythroderma of other causes
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Overview

Title

Management Of Atopic Dermatitis: Diagnosis And Assessment Of Atopic Dermatitis

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