Atopic dermatitis (AD) is the "itch that rashes." Dermatitis means inflammation of the skin. It is an inherited, chronic, relapsing, pruritic skin condition characterized by dry, sensitive skin, inflammation and lichenification of the skin.
Atopic dermatitis is usually the initial manifestation of the triad of atopic disease:
- atopic dermatitis,
- allergic rhinitis.
Immunologically, it is characterized by an increased synthesis of IgE and increased frequency of both circulating and lesional allergen-specific Th2 cells secreting IL-4, IL-5, and IL-13.
The disease impacts patients and their families significantly socially, personally, emotionally and financially.
Many (~75%) outgrow AD, however, quite a few (~25%) continue to have "sensitive" skin even in their adult years.
Which comes first the itch or the rash? Making the diagnosis involves pruritus and several criteria.