Atopic dermatitis (also called “atopic eczema”) is a common skin condition that most often affects infants and children. Between 5- 10% of U.S. children are affected. It is a chronic inflammatory condition marked by a vicious cycle of itching, scratching of the rash by the patient, and then intensified itching. In fact, it is has been called “the itch that rashes”. The origin of the disease is unknown, but it may have a genetic component. Patients with eczema often have the “atopic triad”: atopic dermatitis, asthma, and allergic rhinitis (hay fever). Atopic dermatitis usually starts after 2 months of age, and the majority of patients who develop the rash do so by the age of 5. Nine out of ten children will outgrow the disease by their teens, but symptoms can persist into adulthood. Men and women are equally affected.
The cause of the disease is unknown, although disturbances of the immune and vascular systems have been suggested by researchers. Genetics may also play an important role: family members of patients with atopic dermatitis often have a history of allergic respiratory disease such as asthma or allergic rhinitis.
The disease has an overall chronic course punctuated by acute flare-ups. These flare-ups are thought to be triggered by food allergy, skin infections, irritating chemicals, climate changes, and emotional stressors. The most frequent complication of atopic dermatitis is secondary infection of the rash by a bacteria (Staphylococcus aureus) or a virus (herpes simplex, variola, vaccinia virus). These secondary infections must be promptly treated with the appropriate agent.
