Atopic dermatitis is a chronic, relapsing form of eczema characterized by dry skin and itchy, recurrent lesions. While its exact etiology is unclear, there is a genetic predisposition involving the immune system. Clinically, it presents in two patterns - an infantile onset involving the face and risk of generalization, and a childhood pattern of dry, lichenified plaques on the extremities. Treatment focuses on patient education to avoid scratching, limiting irritant exposure, using mild cleansers, and reducing house dust mites. Dietary restrictions and vaccinations are generally not contraindicated except in specific egg allergies.

1. Atopic dermatitis

2. Definition
It is an acute, sub acute or chronic relapsing, endogenous eczema,
characterized by dry skin and pruritic, recurrent, symmetric dermatitic
lesion.
Etiology is unclear.
Genetic predisposition is an important factor but the inheritance
pattern has not been ascertained.

3. Immunological changes
1.Elevated IgE levels
2.Increased levels of allergen specific IgE
3.Abnormalities of lymphocytes

4. Clinical features and diagnosis
1) Infantile pattern
Atopic dermatitis may have onset after 3 months of age.
Clinical feature-itchy, erythmatous papulovesicles, seen on face but may
become generalized.
The lesions clear by 18 months of age in 40 percent cases while in rest
evolves into childhood pattern

6. 2) Childhood pattern
Characterized by dry lichenified and crusted plaques seen mainly on
antecubital and popliteal fossa, the neck and face.
70 percent cases clear by 10 yrs of age.
Common complications -superimposed bacterial or viral ( herpes simplex,
molluscum contagiosum) and fungal infections.

8. Diagnosis

9. Treatment
4)Parents and the child should be educated about the disease and it's
chronic course.
5)Limited role for dietary restrictions
6) Breastfeeding decreases the chance of developing the disease
1) Parents are educated to avoid scratching, avoid contact with irritants like woolens
and chemicals
2) Mild soaps and cleansing lotions are used.
3) Measures to reduce exposure to house dust mite, e.g using barriers on pillow and
mattresses ,regular vacuuming of room

10. 7) No Contraindications to vaccination except in children specifically allergic
to eggs, in whom influenza and yellow fever vaccines are avoided.

11. Thank you