Atopic dermatitis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Differentiating Atopic Dermatitis from other Diseases
Category | Diseases | Etiology | Inherited | Acquired | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Demography | History | Symptoms | Physical examination | |||||||||||||||||||||||||
Lab Findings | Imaging | Histopathology | ||||||||||||||||||||||||||
Appearance | Itching | Bleeding | Fever | BP | Tenderness | Nail pitting | Other | CBC | ESR/CRP | Electrolytes | BUN/Cr | LFT | ||||||||||||||||
Single/
Multiple |
Rash | Involved areas | Pustule | WBC | Hb | Plt | ||||||||||||||||||||||
Skin disorders | Atopic dermatitis |
| ||||||||||||||||||||||||||
Allergic contact dermatitis[1] |
|
– | + | Any |
|
May be multiple after 1-2 days of exposure | Erythematous well-demarcated papules | Surrounding the area in contact with the offending agent | – | + | – | – | Nl | + | – |
|
Nl to ↑
(Eosinophilia) |
Nl | Nl | Nl | Nl | Nl | Nl | NA | NA | Clinical manifestation + patch test |
| |
Irritant contact dermatitis[2] |
|
– | + | Any, more occupational exposure |
|
Usually single immediately after the exposure | Well-demarcated red patch with a glazed surface | Any area in contact with the irritant | – | + | – | – | Nl | + | – |
|
Nl | Nl | Nl | Nl | Nl | Nl | Nl | NA |
|
Clinical manifestation + patch test |
| |
Seborrheic dermatitis | Any, onset during the 1st days or weeks of life | Greasy scaling on a yellow-red base | Scalp, axilla, and diaper area | – | ||||||||||||||||||||||||
Psoriasis | ||||||||||||||||||||||||||||
Lichen simplex chronicus | ||||||||||||||||||||||||||||
Ichthyosis vulgaris | ||||||||||||||||||||||||||||
Nummular dermatitis | ||||||||||||||||||||||||||||
Netherton's syndrome | ||||||||||||||||||||||||||||
Dubowitz syndrome | ||||||||||||||||||||||||||||
Erythrokeratodermia variabilis | ||||||||||||||||||||||||||||
Diseases | Etiology | Inherited | Acquired | Demography | History | Single/
Multiple |
Rash | Involved areas | Pustule | Itching | Bleeding | Fever | BP | Tenderness | Nail pitting | Other | WBC | Hb | Plt | ESR/CRP | Electrolytes | BUN/Cr | LFT | Imaging | Histopathology | Gold standard | Additional findings | |
Infection | Dermatophytes | |||||||||||||||||||||||||||
Candida | ||||||||||||||||||||||||||||
Herpes simplex | ||||||||||||||||||||||||||||
Staphylococcus aureus | ||||||||||||||||||||||||||||
Molluscum contagiosum | ||||||||||||||||||||||||||||
Scabies |
|
Multiple | Erythematous papular lesions | Flexor wrists, finger webs and genitalia | +++ | |||||||||||||||||||||||
HIV | ||||||||||||||||||||||||||||
Diseases | Etiology | Inherited | Acquired | Demography | History | Single/
Multiple |
Rash | Involved areas | Pustule | Itching | Bleeding | Fever | BP | Tenderness | Nail pitting | Other | WBC | Hb | Plt | ESR/CRP | Electrolytes | BUN/Cr | LFT | Imaging | Histopathology | Gold standard | Additional findings | |
Immunologic disorders | Dermatitis herpetiformis | |||||||||||||||||||||||||||
Pemphigus foliaceus | ||||||||||||||||||||||||||||
Graft-versus-host disease | ||||||||||||||||||||||||||||
Dermatomyositis | ||||||||||||||||||||||||||||
Immune deficiency | Wiskott-Aldrich syndrome | |||||||||||||||||||||||||||
Hyper-IgE syndrome | ||||||||||||||||||||||||||||
DiGeorge syndrome | ||||||||||||||||||||||||||||
Severe combined immunodeficiency (SCID) | ||||||||||||||||||||||||||||
Ataxia telangiectasia | ||||||||||||||||||||||||||||
Diseases | Etiology | Inherited | Acquired | Demography | History | Single/
Multiple |
Rash | Involved areas | Pustule | Itching | Bleeding | Fever | BP | Tenderness | Nail pitting | Other | WBC | Hb | Plt | ESR/CRP | Electrolytes | BUN/Cr | LFT | Imaging | Histopathology | Gold standard | Additional findings | |
Metabolic Diseases | Phenylketonuria | |||||||||||||||||||||||||||
Tyrosinemia | ||||||||||||||||||||||||||||
Histidinemia | ||||||||||||||||||||||||||||
Multiple carboxylase deficiency | ||||||||||||||||||||||||||||
Nutritional deficiencies | Zinc deficiency | |||||||||||||||||||||||||||
Niacin (B3) deficiency | ||||||||||||||||||||||||||||
Pyridoxine (B6) deficiency | ||||||||||||||||||||||||||||
Biotin (B7) deficiency | ||||||||||||||||||||||||||||
Malignancy | Mycosis fungoides | |||||||||||||||||||||||||||
Histiocytosis X | ||||||||||||||||||||||||||||
Medications | Infliximab | |||||||||||||||||||||||||||
Category | Diseases | Etiology | Inherited | Acquired | Demography | History | Single/
Multiple |
Rash | Involved areas | Pustule | Itching | Bleeding | Fever | BP | Tenderness | Nail pitting | Other | WBC | Hb | Plt | ESR/CRP | Electrolytes | BUN/Cr | LFT | Imaging | Histopathology | Gold standard | Additional findings |
References
- ↑ Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas JF (2009). "Allergic and irritant contact dermatitis". Eur J Dermatol. 19 (4): 325–32. doi:10.1684/ejd.2009.0686. PMID 19447733.
- ↑ Bains SN, Nash P, Fonacier L (October 2018). "Irritant Contact Dermatitis". Clin Rev Allergy Immunol. doi:10.1007/s12016-018-8713-0. PMID 30293200.