Type your tag names separated by a space and hit enter

Dermatitis, Atopic

Dermatitis, Atopic is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --



  • A chronic, relapsing, pruritic eczematous condition affecting characteristic sites
  • Early onset cases have coexisting allergen sensitization more often than late onset.
  • Clinical phenotypical presentation is highly variable, suggesting multifactorial pathophysiology.
  • May have significant effect on quality of life for patient and family—similar to that of psoriasis


  • 45% of all cases begin in the first 6 months of life with 95% onset prior to age 5 years.
  • 70% of affected children will have a spontaneous remission before adolescence.
  • Incidence on the rise for the past 3 decades in industrialized countries; overall, affects ~15% of children at some time (United States)
  • Also, may have late-onset dermatitis in adults or relapse of childhood condition—primarily hand eczema
  • Asians and blacks are affected more often than whites.
  • 60% if one parent is affected; rises to 80% if both parents are affected

Etiology and Pathophysiology

  • Two main hypothesis: immunologic with unbalanced immune response and/or skin barrier dysfunction (1)
  • Alteration in stratum corneum results in transepidermal water loss and defect in barrier function.
  • Epidermal adhesion is reduced either as a result of (i) genetic mutation resulting in altered epidermal proteins or (ii) defect in immune regulation causing an altered inflammatory response.
  • Interleukin-31 (IL-31) upregulation is thought to be a major factor in pruritus mediated by cytokines and neuropeptides rather than histamine excess.

  • Recent discovery of association between atopic dermatitis (AD) and mutation in the filaggrin gene (FLG), which codes for a skin barrier protein (2)
  • Both epidermal and immune coding likely involved

Risk Factors

  • “Itch–scratch cycle” (stimulates histamine release)
  • Skin infections
  • Emotional stress
  • Irritating clothes and chemicals
  • Excessively hot or cold climate
  • Food allergy in children (in some cases). Studies of breastfeeding conveying decreased risk versus increased risk are mixed in conclusion (3)[C].
  • Exposure to tobacco smoke
  • Family history of atopy
    • Asthma
    • Allergic rhinitis

Commonly Associated Conditions

  • Food sensitivity/allergy in many cases
  • Asthma
  • Allergic rhinitis
  • Hyper-IgE syndrome (Job syndrome)
    • AD
    • Elevated IgE
    • Recurrent pyodermas
    • Decreased chemotaxis of mononuclear cells

-- To view the remaining sections of this topic, please or purchase a subscription --


Stephens, Mark B., et al., editors. "Dermatitis, Atopic." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116172/all/Dermatitis__Atopic.
Dermatitis, Atopic. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116172/all/Dermatitis__Atopic. Accessed March 22, 2019.
Dermatitis, Atopic. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116172/all/Dermatitis__Atopic
Dermatitis, Atopic [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 22]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116172/all/Dermatitis__Atopic.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Dermatitis, Atopic ID - 116172 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116172/all/Dermatitis__Atopic PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -