• Clinical science

Atopic dermatitis (Atopic eczema)


Atopic dermatitis (AD) is an inflammatory skin disease that typically manifests for the first time in early childhood. Although it often improves during adolescence, it may also become a chronic condition that extends into adulthood. Atopic dermatitis is often associated with other atopic diseases, such as asthma or allergic rhinitis. Although the underlying etiology is not completely understood, genetic components, as well as exogenous and endogenous triggers, are believed to play a role. The main symptoms of atopic dermatitis include severe pruritus and dry skin. Primary treatment involves managing the pruritus and moisturizing the skin. Topical steroids and calcineurin inhibitors may be added if treatment with moisturizers is insufficient. In severe cases, systemic therapy with steroids is required. The main complication of atopic dermatitis is the development of secondary infections.


  • Prevalence: About 8–12% of children and 6–9% of adults are affected. [1][2]
  • Age [3]
    • Onset of symptoms usually occurs between 3–6 months of age.
    • Disease often improves with age.

Epidemiological data refers to the US, unless otherwise specified.


The etiology of atopic dermatitis is not completely understood. However, genetic factors (polygenic inheritance), as well as exogenous and endogenous triggers, may play a role.

Clinical features

The symptoms of atopic dermatitis are variable and often change in the course of a lifetime. Itching and dry skin are usually the main symptoms.


The diagnosis of atopic dermatitis is usually based on patient history and clinical appearance. The American Academy of Dermatology suggests the use of several clinical criteria that need to be fulfilled in order to establish the diagnosis.

Clinical criteria [11]

Histopathology [12]

Severity assessment [11]

  • Scoring system (SCORAD = scoring atopic dermatitis)

Differential diagnoses

The differential diagnoses listed here are not exhaustive.


General measures [11]

  • Avoid triggers:
    • Allergic trigger factors (pets, dust mites, pollen, certain foods)
    • Irritants (clothing, chemicals)
    • Heat
  • Keep the skin moist
  • Manage/eliminate stress
  • Breastfeeding recommended during infancy

Management of AD based on disease severity [15][16]

Treatment of atopic dermatitis
Mild AD Moderate AD Severe AD


We list the most important complications. The selection is not exhaustive.


The symptoms of atopic dermatitis usually improve with age and often resolve completely after puberty. [3]