The most distressing symptom is severe itching, which can interfere with the patient’s sleep as well as daytime performance at school and work.The rash appears differently according to age. Infants tend to suffer from oozing vesicles and crusting on the head and diaper area, which occur with subacute onset. Older children and adults experience a chronic rash characteristically on the inner surface of the elbows (antecubital fossa) and the back of the knees (popliteal fossa). Other affected areas include the neck, face, and upper chest and are usually symmetric on both sides of the body. The hallmark of chronic atopic dermatitis is “lichenification” of the skin: it is thickened, more darkly pigmented than the rest of the body, with accentuated skin fold markings.
