71 Atopic Dermatitis

Atopic Dermatitis

The following features should be considered in the diagnosis of atopic dermatitis (AD) in accordance with the American Academy of Dermatology (AAD) 2014 Guidelines.

  • Essential features (must be present) are as follows:Pruritus
  • Eczema (acute, subacute, chronic):
    1. Typical morphology and age-specific patterns (facial/neck/extensor involvement in children, flexural involvement in any age group, sparing the groin and axillary regions)
    2. chronic or relapsing history

Important features (supports the diagnosis) are as follows:

  • Early age of onset
    1. Atopy: Personal and/or family history
    2. IgE reactivity
  • Xerosis

Associated features (nonspecific but suggest the diagnosis of AD) are as follows:

  • Atypical vascular responses (eg, facial pallor, delayed blanch response)
  • Keratosis pilaris/pityriasis alba/hyperlinear palms/ichthyosis.
  • Ocular/periorbital changes Other regional findings (eg, perioral changes/periauricular lesions)
  • Perifollicular accentuation/lichenification/prurigo

In the acute phase, lesions areĀ intensely pruritic, red, thickened, scaly patches or plaques that may become eroded due to scratching.

In the chronic phase, scratching and rubbing create skin lesions that appear dry and lichenified.


  1. Berke R, Singh A, Guralnick M. Atopic dermatitis: an overview. Am Fam Physician. 2012 Jul 1;86(1):35-42. PMID: 22962911.
  2. https://emedicine.medscape.com/article/1049085-overview