ECZEMA | ATOPIC DERMATITIS

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  • Eczema/ Atopic dermatitis (AD) is a chronic inflammatory skin condition

  • AD disproportionately affects African Americans compared to other races.

  • It can present with itchy reddish-purple, brown, dark, scaly, sometimes thicked patches and plaques anywhere on the body.  Classic AD does occur on flexor surfaces.  Darker-skinned patients tend to present with more "follicular prominence", small bumps on the trunk and extensor surfaces, thickened plaques and nodules, and dark patches.

  • AD is thought to be caused by the interplay between defects in skin proteins reducing the ability to hold on to moisture, autoimmunity, and environmental triggers (e.g. diet, pollution, smoking)  

  • Management includes avoiding triggers, gentle skin care, frequent moisturization, topical anti-inflammatory agents (e.g. corticosteroids, calcineurin inhibitors phosphodiesterase 4 inhibitors), oral anti-inflammatory medications (e.g. cyclosporine, methotrexate), phototherapy, intravenous immunoglobulin, interferon-gamma, and biologics (dupilumab), 

References: 

- Ait-Khaled, N. et al., J.  Allergy 2007, 62, 247

- Kaufman BP, et. al, Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment.  Exp Dermatol. 2018 Apr;27(4):340-357