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JAMA Dermatology Patient Page
December 2014

Atopic Dermatitis

JAMA Dermatol. 2014;150(12):1380. doi:10.1001/jamadermatol.2014.2757

Atopic dermatitis is an itchy rash that comes and goes with redness, scaling, and swelling.

Atopic dermatitis can affect patients’ sleep, daily living, and overall well-being. Damage to the skin barrier in atopic dermatitis allows for increased loss of water resulting in dry, itchy skin, skin infections, and increased skin allergies. Patients with atopic dermatitis may also have allergic diseases such as asthma, hay fever, and food allergies.

Atopic Dermatitis Facts

  • Atopic dermatitis affects more than 1 in 10 US children and 1 in 10 to 14 US adults.

  • Most atopic dermatitis begins in infancy and lasts for years.

  • More than 4 in 5 children with atopic dermatitis have their disease as adults.

  • Up to 6 in 10 adults with atopic dermatitis report first getting their disease as an adult.

  • In infants, it affects the face and scalp. In older children and adults, it affects the creases of the elbows, backs of the knees, front of the neck, wrists, and ankles.

  • Rubbing and scratching results in thickening of the skin and over time worsens the itch.

Atopic Dermatitis in People With Black Skin

  • Atopic dermatitis affects 1 in 5 black children and 1 in 10 white children in the United States.

  • Genetic defects in skin barrier (filaggrin gene) are found in more than 20% of whites and fewer than 5% of blacks with atopic dermatitis.

  • Patients with black skin can have atopic dermatitis show up with:

    • Papular eczema, or brown bumps;

    • Follicular eczema, or accentuation of hair follicles;

    • Lichenoid eczema, or flat-topped bumps from rubbing; and/or

    • Skin more often involved in nonflexural areas.

Diagnosis

Your doctor will ask you about your family history, skin care practices, and environment and will look at your skin and sometimes perform skin biopsies or patch testing, which means putting small samples of substances on your skin to see if they cause an itchy rash.

Treatment

There is no cure for atopic dermatitis. Treatments moisturize and soothe the skin, repair the skin barrier, and calm the itch and inflammation. The treatment will depend on how much of your skin is involved. If only a little skin is affected, use of mild soaps, cool baths or showers, or a lot of skin moisturizer and ointments applied to the skin may be enough. If a large area is involved, then oral medicines, UV light therapy, and other treatments may also be needed.

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For More Information

To find this and other JAMA Dermatology Patient Pages, go to the Patient Page link on the JAMA Dermatology website at http://www.jamaderm.com.

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Article Information
Section Editor: Misha A. Rosenbach, MD
The JAMA Dermatology Patient Page is a public service of JAMA Dermatology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Dermatology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.

Conflict of Interest Disclosures: None reported.

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