This document discusses atopic dermatitis, including its different phases and how it is diagnosed and managed. It presents atopic dermatitis as a chronic inflammatory skin disease characterized by severe itching and describes its infantile phase starting between 3-6 months of age on the cheeks and face. The management of atopic dermatitis involves education, treatment including antibacterial cleansers and avoidance of irritants, and prevention of invasive bacterial infections and recurrences.

1. ATOPIC DERMATITIS
• Definition:
• How to Diagnose ?
• How to Manage ?
• Recent Advances:

2. Atopic Dermatitis
• Different types of presentation with severe
itching : think of Atopic Dermatitis.
• Associated allergic rhinitis, allergic brochitis
may or may not be present.
• Strong family history.

3. Atopic Dermatitis
Infantile phase
Childhood phase
Adult phase

4. Aeitiopathogenesis
• Decrease skin barrier function.
• Increase trans epidermal water loss.
• Increase exogenous proteases from staph.
Aureus / Dust mites with reduce endogenous
protease inhibitors.

5. Infantile phase
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Who is the first to see and diagnose ?
Answer :Pediatrician
Starts at 3-6 month of age.
First sign : in winter xerosis , scaling, localized
erythema with scaling and crusting on cheeks
gradually affecting paranasal area and perioral
area.
• Repeated scratching produces infantile
eczema.Extensor side is affected.
• Few of them have generalized eruptions.

6. Infantile phase
• Starts at 3-6 month of age.
• First sign : in winter xerosis , scaling, localized
erythema with scaling and crusting on cheeks
gradually affecting paranasal area and perioral
area.
• Repeated scratching produces infantile
eczema.Extensor side is affected.
• Few of them have generalized eruptions.

7. Childhood phase
• Inflammations in flexure areas.

8. Mannagement of AD
• Education.
• Treatment.
• Prevention of invasive infections and (MRSA
induced bacteremia , endocarditis ,
osteomylitis , septic arthritis) and recurrences
of atopic dermatitis.

9. Management strategy
• Age of patient
• Stage of AD
• Site and extent of lesion, infections

10. Rx
• Avoid irritants
• Antibacterial Cleansers instead of soaps to
reduce bacterial colonization.
• Full cotton clothing