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Atopic Dermatitis: Overview and Risk Factors

Atopic dermatitis, also known as eczema, is a common chronic skin disease that affects about 20% of people worldwide. It is associated with other markers of atopy, such as asthma, allergic rhinitis, and food allergy. Pathogenesis is not well understood. Signs of disease (inflammation) usually occur early in life and resolve by 6 years of age. However, a significant population has atopic dermatitis that may persist indefinitely.

Presentation varies, depending on patient age and disease severity. In general, children have itching and subsequent erythematous plaques or patches with scaling and papular features on the upper body. Adults tend to have thickened skin with lichenification and excoriated and fibrotic papules, reflecting the chronicity of the disease. Severe cases may present in any distribution. Patients with atopic dermatitis are at increased risk for skin infections.

Risk Factors

Family or personal history of atopy. Maternal disease seems to be a stronger risk factor than paternal disease.1 About one–half of those with atopic dermatitis have a relative with allergic asthma. A history of food allergy, allergic rhinitis, or asthma is associated with atopic dermatitis.

Antigens. Variations in antigen exposure may affect risk of disease.2

Some evidence suggests that exclusive breast–feeding for at least the first 3 months of life may be associated with reduced risk among infants with a family history of atopy.3

Atopic Dermatitis: Diagnosis and Treatment >>