Atopic Dermatitis and Ichthyosis

Objectives

After completing this article, readers should be able to:

1. Identify the characteristic features of atopic dermatitis and the factors that worsen it.

2. Understand that children who have atopic dermatitis are prone to recurrent infections, particularly with Staphylococcus aureus and herpes simplex virus.

3. Know the signs of Wiskott-Aldrich syndrome.

4. Plan the appropriate treatment of atopic dermatitis (emollients, corticosteroids, antibiotics, and allergen elimination when appropriate).

5. Recognize ichthyosis vulgaris and know that ichthyosis commonly occurs in children who have atopic dermatitis.

6. List the effective therapies in the management of ichthyosis vulgaris.

7. Distinguish between tinea pedis and atopic dermatitis.

8. Discuss the relationship of atopic dermatitis and food allergies and how to evaluate a patient who has both.

9. Explain why children who have one component of atopy syndrome (allergic rhinitis, asthma, atopic dermatitis) have a threefold greater risk of developing a second component.

Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, relapsing dermatosis that features dry skin (xerosis), pruritus, and a personal or family history of eczema, allergic rhinitis or allergies, or asthma. Children who have one component of the atopic triad (AD, asthma, allergic rhinitis) are three times as likely to develop a second component. There is no sex predilection, and the onset frequently is in infancy. Although many affected children outgrow the condition by age 5 years, AD may persist into adolescence and adulthood. A smaller percentage of patients experience the onset of AD as older children or in adulthood.

The incidence and prevalence of AD have increased in the United States and worldwide, particularly in developed nations. Fewer than 10% of children were affected in the 1970s, but recent epidemiologic studies estimate that 15% to 20% …