About atopic dermatitis

Atopic dermatitis (AD), commonly referred to as eczema, is a chronic inflammatory skin disease that is characterized by dry, itchy, red, swollen, and/or cracked skin.1,2

AD is one of the most common inflammatory skin diseases.3 In the US, more than 16.5 million adults and 9.6 million children have AD.4,5 Worldwide, AD affects approximately 15–30% of children and 2–10% of adults in developed countries.1

While it can occur at any age, AD most often starts in childhood, causing a rash on the face, limbs, or other body areas.1 People with AD are more likely to have other allergic conditions, like asthma, allergic rhinitis, and food allergy.6

Figure 1. Atopic Dermatitis

Clinical features of atopic dermatitis

AD is a relapsing and remitting condition, meaning people can experience multiple flares per year and over the course of many years or their entire lifetime.7 It is not contagious and cannot be transmitted by touching someone who has it.

AD is typically characterized by dry, scaly skin, itching, and redness, with lesions that may ooze and form crusted patches.1,3 AD often affects the folds of the arms, back of the knees, hands, face, and neck.1,2

Itching is an especially bothersome symptom in AD, and tends to worsen at night, disturbing sleep and causing fatigue, which in children can lead to inattention at school.1,6 People with AD may also experience social and emotional distress due to the visibility and discomfort of the disease.3

Causes of atopic dermatitis

AD is regarded as a multifactorial disease and, while the exact cause is not fully understood, it involves both genetic and environmental factors.1

Impaired skin function and abnormal immune responses contribute to the development of AD.1 The skin in AD appears to be defective in its ability to retain moisture and function as a physical barrier.4 Without this barrier function, irritants and allergens can more easily trigger inflammatory reactions.4 Allergic (immune) responses also increase in AD, causing long-term inflammation.1

Environmental factors such as dryness, extremes of temperature, food, soaps and other irritants, allergies, and stress have all been identified as potential triggers.4

Useful links

National Eczema Association

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  1. Bieber T. Atopic dermatitis. New England Journal of Medicine. 2008;358(14):1483-1494.
  2. Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. Journal of the American Academy of Dermatology. 2014;70(2):338-351.
  3. Paller AS, Kabashima K, Bieber T. Therapeutic pipeline for atopic dermatitis: End of the drought? The Journal of Allergy and Clinical Immunology. 2017;140(3):633-643.
  4. National Eczema Association. https://nationaleczema.org/research/eczema-facts/. Accessed November 2020.
  5. Sidbury R, Khorsand K. Evolving Concepts in Atopic Dermatitis. Current Allergy and Asthma Reports. 2017;17(7):42.
  6. Langan SM, Thomas KS, Williams HC. What is meant by a ‘flare’ in atopic dermatitis? A systematic review and proposal. Archives of Dermatology. 2006;142(9):1190-1196.

The information presented on this website is intended for educational purposes only. Readers are encouraged to consult their healthcare providers for further information.