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{{Atopic dermatitis}}
{{Atopic dermatitis}}


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{{CMG}}; {{AE}} [[Ogechukwu Hannah Nnabude, MD]]; {{S.S}}


==Overview==
The [[symptoms]] of atopic dermatitis usually start during the first few years of life, and present as intense [[pruritus]] and chronic and relapsing age dependent [[Eczema|eczematous]] [[lesions]]. Common [[complications]] of atopic dermatitis include super-infection with [[Staphylococcus aureus|staphylococcus ''aureus'']]'','' [[herpes simplex virus]], and [[molluscum contagiosum]]; [[Sleep disturbances|sleep problems]] due to intense [[pruritus]], [[ocular]] comorbidities, and [[striae]] formation due to long term use of topical [[corticosteroids]].
==Natural History, Complications, and Prognosis==


{{CMG}}
===Natural History===


*The [[symptoms]] of atopic dermatitis usually start during the first few years of life, and present as intense [[pruritus]] and chronic and relapsing age dependent [[Eczema|eczematous]] lesions.<ref name="pmid23452057">{{cite journal |vauthors=Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N |title=Characterization of different courses of atopic dermatitis in adolescent and adult patients |journal=Allergy |volume=68 |issue=4 |pages=498–506 |date=April 2013 |pmid=23452057 |doi=10.1111/all.12112 |url=}}</ref>
*The majority of infants and children with atopic dermatitis usually grow out of the disease during childhood.<ref name="pmid23301666">{{cite journal |vauthors=Burr ML, Dunstan FD, Hand S, Ingram JR, Jones KP |title=The natural history of eczema from birth to adult life: a cohort study |journal=Br. J. Dermatol. |volume=168 |issue=6 |pages=1339–42 |date=June 2013 |pmid=23301666 |doi=10.1111/bjd.12216 |url=}}</ref>
*In severe cases, atopic dermatitis continues or relapses in adulthood.<ref name="pmid234520573">{{cite journal |vauthors=Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N |title=Characterization of different courses of atopic dermatitis in adolescent and adult patients |journal=Allergy |volume=68 |issue=4 |pages=498–506 |date=April 2013 |pmid=23452057 |doi=10.1111/all.12112 |url=}}</ref>
*The natural history of atopic dermatitis can be categorized into various subtypes according to the clinical features.
**The most common subtype was characterized by the early onset of atopic dermatitis (<2 years) and persistent until adulthood.<ref name="pmid234520574">{{cite journal |vauthors=Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N |title=Characterization of different courses of atopic dermatitis in adolescent and adult patients |journal=Allergy |volume=68 |issue=4 |pages=498–506 |date=April 2013 |pmid=23452057 |doi=10.1111/all.12112 |url=}}</ref>
*In the sequence of atopy march diseases, atopic dermatitis is the first to commence during infancy, followed by [[allergic rhinitis]], [[food allergy]] and [[asthma]] later in life.<ref name="pmid20674819">{{cite journal |vauthors=Spergel JM |title=From atopic dermatitis to asthma: the atopic march |journal=Ann. Allergy Asthma Immunol. |volume=105 |issue=2 |pages=99–106; quiz 107–9, 117 |date=August 2010 |pmid=20674819 |doi=10.1016/j.anai.2009.10.002 |url=}}</ref>
*Atopic dermatitis is a life long [[disease]] with periods of waxing and waning [[Eczema|eczematous]] [[skin lesions]].<ref name="pmid24696036">{{cite journal |vauthors=Margolis JS, Abuabara K, Bilker W, Hoffstad O, Margolis DJ |title=Persistence of mild to moderate atopic dermatitis |journal=JAMA Dermatol |volume=150 |issue=6 |pages=593–600 |date=June 2014 |pmid=24696036 |pmc=4352328 |doi=10.1001/jamadermatol.2013.10271 |url=}}</ref>
*


===Complications===


==Complications==
*Common complications of atopic dermatitis include:
**[[Super-infection]]
***[[Staphylococcus aureus|Staphylococcus ''aureus'']]<ref name="pmid21070347">{{cite journal |vauthors=Matiz C, Tom WL, Eichenfield LF, Pong A, Friedlander SF |title=Children with atopic dermatitis appear less likely to be infected with community acquired methicillin-resistant Staphylococcus aureus: the San Diego experience |journal=Pediatr Dermatol |volume=28 |issue=1 |pages=6–11 |date=2011 |pmid=21070347 |doi=10.1111/j.1525-1470.2010.01293.x |url=}}</ref><ref name="StänderRopper2021">{{cite journal|last1=Ständer|first1=Sonja|last2=Ropper|first2=Allan H.|title=Atopic Dermatitis|journal=New England Journal of Medicine|volume=384|issue=12|year=2021|pages=1136–1143|issn=0028-4793|doi=10.1056/NEJMra2023911}}</ref>
***[[Herpes simplex]] virus ( Kaposi varicelliform eruption or [[eczema herpeticum]]) - occurs in <3% of patients
***[[Molluscum contagiosum]]
**[[Sleep disturbances|Sleep problems]] due to intense [[pruritus]]
**[[Ocular]] comorbidities
***[[Atopic keratoconjunctivitis]]<ref name="pmid24342754">{{cite journal |vauthors=Chen JJ, Applebaum DS, Sun GS, Pflugfelder SC |title=Atopic keratoconjunctivitis: A review |journal=J. Am. Acad. Dermatol. |volume=70 |issue=3 |pages=569–75 |date=March 2014 |pmid=24342754 |doi=10.1016/j.jaad.2013.10.036 |url=}}</ref>
***[[Vernal keratoconjunctivitis]]<ref name="pmid25744396">{{cite journal |vauthors=Pattnaik L, Acharya L |title=A comprehensive review on vernal keratoconjunctivitis with emphasis on proteomics |journal=Life Sci. |volume=128 |issue= |pages=47–54 |date=May 2015 |pmid=25744396 |doi=10.1016/j.lfs.2015.01.040 |url=}}</ref>
***[[Keratoconus]]
***Infectious [[keratitis]]
***[[Blepharitis]]
**Topical [[corticosteroids]] can lead to [[striae]] formation
**[[Atopy]] march: Other atopic disorders such as [[allergic rhinitis]], [[food allergy]] and [[asthma]]<ref name="StänderRopper2021">{{cite journal|last1=Ständer|first1=Sonja|last2=Ropper|first2=Allan H.|title=Atopic Dermatitis|journal=New England Journal of Medicine|volume=384|issue=12|year=2021|pages=1136–1143|issn=0028-4793|doi=10.1056/NEJMra2023911}}</ref>
**[[Depression]], [[anxiety]] and [[suicidality]] are among long-term complications of atopic dermatitis.<ref name="pmid23452057">{{cite journal |vauthors=Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N |title=Characterization of different courses of atopic dermatitis in adolescent and adult patients |journal=Allergy |volume=68 |issue=4 |pages=498–506 |date=April 2013 |pmid=23452057 |doi=10.1111/all.12112 |url=}}</ref>


* Infections of the [[skin]] caused by [[bacteria]], [[fungi]], or [[virus]]es
===Prognosis===
* Permanent scars
* Side effects from long-term use of medicines to control [[eczema]]


==Prognosis==
*[[Atopic dermatitis]] is a [[chronic disease]] with varying subtypes.<ref name="pmid15131576">{{cite journal |vauthors=Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U |title=The natural course of atopic dermatitis from birth to age 7 years and the association with asthma |journal=J. Allergy Clin. Immunol. |volume=113 |issue=5 |pages=925–31 |date=May 2004 |pmid=15131576 |doi=10.1016/j.jaci.2004.01.778 |url=}}</ref>
 
*The presence of severe atopic dermatitis and early [[atopic]] sensitization is associated with a particularly poor prognosis.<ref name="pmid151315762">{{cite journal |vauthors=Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U |title=The natural course of atopic dermatitis from birth to age 7 years and the association with asthma |journal=J. Allergy Clin. Immunol. |volume=113 |issue=5 |pages=925–31 |date=May 2004 |pmid=15131576 |doi=10.1016/j.jaci.2004.01.778 |url=}}</ref>
Atopic dermatitis is a long-term condition. You can control it with treatment, by avoiding irritants, and by keeping the skin well-moisturized.
*[[Mortality]] is unusual in atopic dermatitis.
In children, the condition often starts to go away around age 5 - 6, but flare-ups will often occur. In adults, the problem is generally a long-term or returning condition.
Atopic dermatitis may be harder to control if it:
 
* Begins at an early age
* Involves a large amount of the body
* Occurs along with [[allergic rhinitis]] and [[asthma]]
* Occurs in someone with a family history of [[eczema]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 06:22, 16 October 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD; Shalinder Singh, M.B.B.S.[2]

Overview

The symptoms of atopic dermatitis usually start during the first few years of life, and present as intense pruritus and chronic and relapsing age dependent eczematous lesions. Common complications of atopic dermatitis include super-infection with staphylococcus aureus, herpes simplex virus, and molluscum contagiosum; sleep problems due to intense pruritus, ocular comorbidities, and striae formation due to long term use of topical corticosteroids.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of atopic dermatitis usually start during the first few years of life, and present as intense pruritus and chronic and relapsing age dependent eczematous lesions.[1]
  • The majority of infants and children with atopic dermatitis usually grow out of the disease during childhood.[2]
  • In severe cases, atopic dermatitis continues or relapses in adulthood.[3]
  • The natural history of atopic dermatitis can be categorized into various subtypes according to the clinical features.
    • The most common subtype was characterized by the early onset of atopic dermatitis (<2 years) and persistent until adulthood.[4]
  • In the sequence of atopy march diseases, atopic dermatitis is the first to commence during infancy, followed by allergic rhinitis, food allergy and asthma later in life.[5]
  • Atopic dermatitis is a life long disease with periods of waxing and waning eczematous skin lesions.[6]

Complications

Prognosis

References

  1. ↑ 1.0 1.1 Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N (April 2013). "Characterization of different courses of atopic dermatitis in adolescent and adult patients". Allergy. 68 (4): 498–506. doi:10.1111/all.12112. PMID 23452057.
  2. ↑ Burr ML, Dunstan FD, Hand S, Ingram JR, Jones KP (June 2013). "The natural history of eczema from birth to adult life: a cohort study". Br. J. Dermatol. 168 (6): 1339–42. doi:10.1111/bjd.12216. PMID 23301666.
  3. ↑ Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N (April 2013). "Characterization of different courses of atopic dermatitis in adolescent and adult patients". Allergy. 68 (4): 498–506. doi:10.1111/all.12112. PMID 23452057.
  4. ↑ Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, Novak N (April 2013). "Characterization of different courses of atopic dermatitis in adolescent and adult patients". Allergy. 68 (4): 498–506. doi:10.1111/all.12112. PMID 23452057.
  5. ↑ Spergel JM (August 2010). "From atopic dermatitis to asthma: the atopic march". Ann. Allergy Asthma Immunol. 105 (2): 99–106, quiz 107–9, 117. doi:10.1016/j.anai.2009.10.002. PMID 20674819.
  6. ↑ Margolis JS, Abuabara K, Bilker W, Hoffstad O, Margolis DJ (June 2014). "Persistence of mild to moderate atopic dermatitis". JAMA Dermatol. 150 (6): 593–600. doi:10.1001/jamadermatol.2013.10271. PMC 4352328. PMID 24696036.
  7. ↑ Matiz C, Tom WL, Eichenfield LF, Pong A, Friedlander SF (2011). "Children with atopic dermatitis appear less likely to be infected with community acquired methicillin-resistant Staphylococcus aureus: the San Diego experience". Pediatr Dermatol. 28 (1): 6–11. doi:10.1111/j.1525-1470.2010.01293.x. PMID 21070347.
  8. ↑ 8.0 8.1 Ständer, Sonja; Ropper, Allan H. (2021). "Atopic Dermatitis". New England Journal of Medicine. 384 (12): 1136–1143. doi:10.1056/NEJMra2023911. ISSN 0028-4793.
  9. ↑ Chen JJ, Applebaum DS, Sun GS, Pflugfelder SC (March 2014). "Atopic keratoconjunctivitis: A review". J. Am. Acad. Dermatol. 70 (3): 569–75. doi:10.1016/j.jaad.2013.10.036. PMID 24342754.
  10. ↑ Pattnaik L, Acharya L (May 2015). "A comprehensive review on vernal keratoconjunctivitis with emphasis on proteomics". Life Sci. 128: 47–54. doi:10.1016/j.lfs.2015.01.040. PMID 25744396.
  11. ↑ Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U (May 2004). "The natural course of atopic dermatitis from birth to age 7 years and the association with asthma". J. Allergy Clin. Immunol. 113 (5): 925–31. doi:10.1016/j.jaci.2004.01.778. PMID 15131576.
  12. ↑ Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann B, Wahn U (May 2004). "The natural course of atopic dermatitis from birth to age 7 years and the association with asthma". J. Allergy Clin. Immunol. 113 (5): 925–31. doi:10.1016/j.jaci.2004.01.778. PMID 15131576.
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