The clinical spectrum of atopic dermatitis

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Presentation transcript:

The clinical spectrum of atopic dermatitis Vincent S. Beltrani, MD Journal of Allergy and Clinical Immunology Volume 104, Issue 3, Pages S87-S98 (September 1999) DOI: 10.1016/S0091-6749(99)70050-3 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 1 Distribution of eczema in relation to age. From Sedlis, E. Natural history of infantile eczema: its incidence and course. In Conference on Infantile Eczema (L. Emmett Holt, circa 1950). Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 2 Subacute eczema in antecubital fossa of a young lady with eczema since childhood. Note some lichenification, scaliness, and fine vesicles scattered throughout the erythematous papular plaque. Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 3 Acute/subacute eczema in popliteal fossa of a 12-year-old child. Note eroded and excoriated vesiculopapular plaques. Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 4 Acute facial eczema in a 4-month-old infant. Note complete sparing of nasal skin, known as the “headlight sign,” considered pathognomonic for AD. Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 5 Acute facial flare-up of chronic eczema in a 19-year-old girl. Note “headlight sign.” (From Beltrani VS. The clinical aspects of atopic dermatitis. In: Leung DYM, ed. Atopic Dermatitis: From Pathogenesis to Treatment. Austin, TX: R G Landes Publishers; 1996.) Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 6 Excoriated lichenified eczema of antecubital fossa. Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 7 Acute oozing AD on the face of a 6-month-old infant. Within 48 hours of the facial rash, the eczema generalized. This is often the clinical presentation of Staphylococcus aureus superantigenicity, requiring both systemic corticosteroids and antibiotics for control. (From Beltrani VS. The clinical aspects of atopic dermatitis. In: Leung DYM, ed. Atopic Dermatitis: From Pathogenesis to Treatment. Austin, TX: R G Landes Publishers; 1996.) Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 8 Chronic lichenified AD of the nape of the neck of a 30-year-old woman, who admitted to scratching the area “for years.” Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 9 Atopy/other eczemas cartoon. (From All About Atopic Dermatitis [brochure]. Portland, Ore: National Eczema Association for Science and Education.) Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 10 Juvenile plantar dermatitis (plantar AD) of an 8-year-old girl. Atopic prepubertal youngsters with the absence of interdigital-space involvement are frequently unsuccessfully treated as “athlete’s foot.” (From Beltrani VS. The clinical aspects of atopic dermatitis. In: Leung DYM, ed. Atopic Dermatitis: From Pathogenesis to Treatment. Austin, TX: R G Landes Publishers; 1996.) Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 11 Nipple dermatitis in an adult atopic woman. Despite having minimal eczema over the rest of her body, her chronic nipple dermatitis would often flare acutely. Her bilateral nipple involvement negates the need to rule out Paget’s disease. (From Beltrani VS. The clinical aspects of atopic dermatitis. In: Leung DYM, ed. Atopic Dermatitis: From Pathogenesis to Treatment. Austin, TX: R G Landes Publishers; 1996.) Journal of Allergy and Clinical Immunology 1999 104, S87-S98DOI: (10.1016/S0091-6749(99)70050-3) Copyright © 1999 Mosby, Inc. Terms and Conditions