About Atopic Dermatitis

Atopic Dermatitis (AD) is a chronic inflammatory skin disease commonly seen in infants and children. This condition is typically associated with hyperreactivity to environmental triggers.1 AD usually presents during early infancy and childhood and regresses by adolescence, but it can present in adulthood.2

The clinical pattern of AD may vary with age. Infants typically present with erythematous patches, papules and plaques on the cheeks, forehead, or scalp. Children (ages 2 – puberty) exhibit more lichenfied papules and plaques on the flexures, hands, feet, wrists, and ankles. The adult phase (puberty – adulthood) generally involves affected areas including: flexural folds, neck/face, upper arms and back, and the dorsa of the hands, feet, fingers, and toes.3

AD is associated with Staphyloccocus (Staph) aureus skin colonization, which is typically managed with antimicrobial therapies.​Alkalization of the skin barrier by ​utilizing ​vinegar baths is a potential treatment target for skin biome diversification (balance of the good bacteria on the skin).5 Aseptic soaks with bleach baths may also be utilized to reduce Staph colonization. Topical corticosteroids and immune modulators (TIMS), are often utilized to temporarily alleviate flares.6

  1. Leung DY. New insights into atopic dermatitis. Journal of Clinical Investigation. 2004;113(7):651-657.
  2. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. Journal of Allergy and Clinical Immunology. 2003; 112(6):128-139.
  3. Akdis CA, Akdis M, Bieber T, et al. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology
    and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. Journal of Allergy and
    Clinical Immunology. 2006;118(1):969-987.
  4. Kong HH, Oh J, Deming C, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic
    dermatitis. Genome Research. 2017; 22:850-859.
  5. Panther D, Jacob S. The Importance of Acidification in Atopic Eczema: An Underexplored Avenue for Treatment. Journal of Clinical
    Medicine. 2015;4(5):970-978.
  6. Jacob SE, Miller J, Herro EM. Treating Atopic Dermatitis. Supplement to Skin and Aging. 2011.