Fast Five Quiz: Dermatitis

William James, MD

Disclosures

November 04, 2020

Incessant pruritus (itchiness) is the central and most debilitating symptom of atopic dermatitis. According to guidelines from the American Academy of Dermatology (AAD), essential features that must be present for diagnosis include pruritus and eczema (acute, subacute, chronic). Typical morphology and age-specific patterns include facial, neck, and extensor involvement in infants and children; current or previous flexural lesions in any age group; and sparing of the groin and axillary regions.

Important features seen in most cases that add support to (but are not required for) diagnosis include early age of onset, asthma, seasonal allergies, and xerosis. Associated features that support the diagnosis of atopic dermatitis but are too nonspecific include the following:

  • Atypical vascular responses (eg, facial pallor, white dermographism, delayed blanch response)

  • Keratosis pilaris, pityriasis alba, hyperlinear palms, ichthyosis

  • Ocular or periorbital changes

  • Other regional findings (eg, perioral changes or periauricular lesions)

  • Perifollicular accentuation, lichenification, prurigo lesions

Read more about the presentation of atopic dermatitis.

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