Physician Assistant (PA)
Immunodermatologic Disorders
Atopic Dermatitis / Eczema

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Atopic Dermatitis / Eczema

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Atopic Dermatitis / Eczema

A-top-hat Rash and Ax-zebra
Atopic dermatitis, also known as eczema is a chronic inflammatory skin condition. Patients often experience a pruritic, erythematous, vesicular rash that occurs on the cheeks in infants and the flexural areas in adults. Atopic dermatitis is highly associated with other atopic diseases like asthma and allergic rhinitis. The preferred management of atopic dermatitis is a multi-pronged approach to avoid triggers, restore the skin barrier function and treat the inflammation. Treatment depends on severity but may include moisturizers, corticosteroids, tacrolimus, antihistamines and phototherapy.
Pruritic Vesicles
Prairie-dog in Vest

Patients classically present with a pruritic and erythematous vesicular rash. These vesicles may ooze when scratched and crust over when they heal.

Inflammatory Skin Rash
Skin-suit In-flames

Atopic dermatitis, also known as eczema, is a chronic inflammatory skin rash. The rash occurs in a relapsing and remitting pattern.

Cheeks in Children
Cheeks of Children

In infants to children 2 years old, the most commonly involved areas are the cheeks and extensor surfaces.

Skin Flexural Areas
Skin-suit Flexing

In children older than 2 years old and adults, the most commonly involved areas are the flexural areas (e.g. neck, antecubital fossae and popliteal fossae).

Associated with Asthma and Allergic Rhinitis
Asthma-inhaler and Runny-nose Allergy-alligator

Atopy is a predisposition towards developing certain allergic hypersensitivity reactions such as eczema, allergic rhinitis (hay fever) and asthma. Therefore, a history of atopic dermatitis is a strong risk factor for the development of asthma or allergic rhinitis.


Tacrolimus is available as a topical ointment for the treatment of atopic dermatitis. Tacrolimus is a nonsteroidal immunomodulating agent that works locally to suppress the release of inflammatory mediators via calcineurin inhibition. Unlike topical corticosteroids, tacrolimus does not cause skin atrophy, so it is often used in thin-skinned areas such as the face. However, these agents are used with caution due to a possible link between tacrolimus and lymphoma.


Skin hydrating moisturizers are an important component of atopic dermatitis treatment. The use of moisturizers serves to hydrate the stratum corneum and maintain the lipid barrier. It is recommended that patients apply moisturizers immediately after bathing in order to maintain proper skin hydration.


Topical corticosteroids are used to suppress cutaneous inflammation in mild to moderate atopic dermatitis. For severe atopic dermatitis in adolescents or adults, especially during acute flares, systemic corticosteroids may be used.


In adolescents and adults with moderate to severe atopic dermatitis, phototherapy treatment may be implemented if topical therapy has failed.

Avoid Triggers
Avoid-sign with Trigger

Avoiding triggers is key to the management of atopic dermatitis. Common triggers include low humidity, dry skin, excessive heat, exposure to detergents or irritants, dust mites, animal dander and UV light.


Oral and topical antihistamines are used to provide symptomatic relief of pruritus and break the itch-scratch-itch cycle.


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