Atopic Dermatitis (infantile type)

Diagnosis: Atopic Dermatitis (infantile type)

Ill-defined, erythematous, scaly, and crusted (eczematous) patches with exudation localized to the cheeks and chin.

Clinical Presentation

Ill-defined, erythematous, scaly, and crusted (eczematous) patches with exudation localized to the cheeks and chin.

Clinical History

Submitted by Alaa Saad. Originally posted October 12, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Contact dermatitis (allergic or irritant) • Seborrheic dermatitis • Psoriasis • Scabies • Nummular eczema • Mycosis fungoides (cutaneous T-cell lymphoma) • Dermatitis herpetiformis

Key Learnings

• Part of the atopic triad (eczema, asthma, allergic rhinitis) • Filaggrin gene mutations (FLG) identified as major predisposing factor — impaired skin barrier • Eczema herpeticum is a serious complication requiring urgent antiviral therapy • The "itch that rashes" — pruritus precedes skin lesions • Age-dependent morphology: infantile (face, extensor), childhood (flexural), adult (hands, face, flexural) • Dupilumab (anti-IL-4/IL-13) revolutionized treatment of moderate-severe AD

Tags: atopic, dermatitis, infantile, type, alaa saad