2nd July 2023

Atopic Eczema

The most common type of eczema which typically presents in childhood. It usually occurs from prolonged hypersensitivity to common environmental allergens, such as pollen or house dust mite. Individuals who suffer from atopy also have a predisposition to produce excess IgE causing the atopic response. Other atopic conditions include hay fever, asthma, or food allergies. Eczema is a clinical diagnosis based on history and examination. The main diagnostic criteria for atopic eczema include at least three of the following:

• Onset before 2 years of age
• History of itch in the skin creases (or cheeks if <4)
• History of asthma/hay fever (or in first degree relative if <4)
• Dry skin (xeroderma)
• Visible flexural dermatitis (cheeks, forehead, outer limbs if <4)

The distribution of the rash often varies with age. In babies and infants, it often presents on the face and trunk compared to the flexures in children. In adults, the rash can be widespread, affecting the face, trunk, and limbs (not restricted to flexures). An image of an eczematous rash can be seen below:

Image Source: Wikimedia Commons (2015). Dermatite o eczema atopico avambraccio 2015, Licensed under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:Dermatite_o_eczema_atopico_avambraccio_2015.jpg (Accessed on: 14 March 2023).