Skill Checkup: A 32-Year-Old Man With a History of Atopic Dermatitis Presents With Worsening Itch

Diamant Thaçi, MD, PhD; Alan Irvine, MD, DSc


July 13, 2023

Involvement of ≥ 10% BSA is one of the key features of moderate to severe AD. However, there are other determinants of severity that may take precedence regardless of the extent of BSA involved. In a 2023 international survey of patients with AD, the itch was the most bothersome AD symptom reported. The presence of bothersome itch and prominent redness of the involved areas with infiltration/papulation are also signs of moderate to severe AD. Additionally, if the lesions are in areas that are highly visible or important for function (soles, palms, neck and face), the disease may still be considered moderate to severe even if involved BSA is < 10%; the same applies to significantly reduced quality of life (interference with sleep or daily activities).

On the basis of any of these criteria, this patient has moderate to severe AD.


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