Fast Five Quiz: Atopic Dermatitis

Richard P. Vinson, MD; William James, MD


February 09, 2023

Figure 1. Atopic dermatitis.

The progression of allergic diseases, beginning with AD, is referred to as the "atopic march" or "allergic march." Typically, the atopic march commences with AD and progresses to IgE-mediated food allergy, asthma, and allergic rhinitis. Each of these conditions has a complex pathophysiology involving numerous facets of the immune system. About one third of patients with AD will develop asthma or develop allergic rhinitis. Primary findings of AD include xerosis, lichenification, and eczematous lesions.

Seborrheic dermatitis (SD) is not included in the progression of allergic diseases, but it may be confused with AD. However, the scaling associated with AD tends to be dry and crusty as opposed to the yellow, greasy scales typical of SD.

Lichenification, or thickened areas of skin, is a sign of chronic AD and develops as a result of long-term rubbing of the skin, typically over skin folds, bony prominences, and the forehead.

Like SD, contact dermatitis is not included in the progression of allergic diseases. It may mimic AD or occur concomitantly with it, so in certain circumstances it needs to be excluded before a firm diagnosis of AD is made. Isolated allergic or irritant contact dermatitis results from exposure to a skin irritant and will resolve upon discontinuation of the exposure.

Learn more about the progression of AD.


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