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Complications of atopic dermatitis

Authors: Dr Amy Stanway, Department of Dermatology, Waikato (Feb 2004); Updated: Dr Aysha Rashid, Medical Registrar, Auckland; Associate Professor Paul Jarrett, Dermatologist, Middlemore Hospital and Department of Medicine, The University of Auckland, New Zealand (Aug 2021)


Infective complications of atopic dermatitis

Skin infection is very common in atopic dermatitis due to an inherently abnormal skin barrier, cutaneous and systemic immune system abnormalities, and scratching the itch. Cutaneous colonisation by Staphylococcus aureus forms a bacterial biofilm and worsens the dermatitis by promoting the Th2 allergic inflammatory response. Infants are particularly at risk of severe skin infections.

Bacterial skin infections in atopic dermatitis

Bacterial infection and atopic dermatitis

Viral skin infections in atopic dermatitis

Molluscum contagiosum infection and atopic dermatitis

Eczema herpeticum

Fungal skin infections in atopic dermatitis

Fungal infection and atopic dermatitis

Complications of skin infections in atopic dermatitis

Contact dermatitis and atopic dermatitis

Contact dermatitis should be considered in the atopic patient with an otherwise unexplained dermatitis flare, particularly if in a patterned distribution.

Irritant contact dermatitis and atopic dermatitis

Irritant contact dermatitis is particularly common with atopic dermatitis due to the abnormal skin barrier function. Atopic hand dermatitis and occupational skin disease are frequent manifestations.

Allergic contact dermatitis and atopic dermatitis

The frequent use of multiple topical treatments for atopic dermatitis increases the risk of allergic contact dermatitis due to exposure to potential allergensAeroallergens also commonly aggravate other manifestations of atopy such as hay fever and asthma.

Contact dermatitis and atopic dermatitis

Complications of atopic dermatitis in skin of colour 

Dyspigmentation due to atopic dermatitis in skin of colour

Other complications of atopic dermatitis

  • Erythroderma and its complications in atopic dermatitis
  • Psychological effects of atopic dermatitis
  • Ophthalmological complications of atopic dermatitis
    • Vernal keratoconjunctivitis in children
      • Blepharitis, infectious keratitis, keratoconus
    • Atopic keratoconjunctivitis in adults
      • Corneal scarring, loss of vision
    • Herpes keratoconjunctivitis in eczema herpeticum
    • Cataracts
      • Bilateral with characteristic appearance on eye examination
      • Associated with severe atopic dermatitis
      • Onset around age 15–25 years
  • Growth
    • Severe dermatitis may slow the growth rate of children
    • Growth retardation can be due to the dermatitis itself and/or treatment such as systemic corticosteroids
    • Dietary restrictions may affect growth and, in extreme cases, cause protein-energy malnutrition

Other complications of atopic dermatitis



  • Boonstra M, Rustemeyer T, Middelkamp-Hup MA. Both children and adult patients with difficult-to-treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized. J Eur Acad Dermatol Venereol. 2018;32(9):1554–61. doi:10.1111/jdv.14973. Journal
  • Drucker AM. Atopic dermatitis: burden of illness, quality of life, and associated complications. Allergy Asthma Proc. 2017;38(1):3–8. doi:10.2500/aap.2017.38.4005. PubMed
  • Hsu JI, Pflugfelder SC, Kim SJ. Ocular complications of atopic dermatitis. Cutis. 2019;104(3):189–93. Journal
  • Jacob SE, McGowan M, Silverberg NB, et al. Pediatric Contact Dermatitis Registry data on contact allergy in children with atopic dermatitis. JAMA Dermatol. 2017;153(8):765–70. doi:10.1001/jamadermatol.2016.6136. PubMed Central
  • Jeter J, Bowen C. Atopic dermatitis and implications for military service. Mil Med. 2019;184(5-6):e177–82. doi:10.1093/milmed/usy427. Journal
  • Kim KH. Clinical pearls from atopic dermatitis and its infectious complications. Br J Dermatol. 2014;170 Suppl 1:25–30. doi:10.1111/bjd.12919. Journal
  • Owen JL, Vakharia PP, Silverberg JI. The role and diagnosis of allergic contact dermatitis in patients with atopic dermatitis. Am J Clin Dermatol. 2018;19(3):293–302. doi:10.1007/s40257-017-0340-7. PubMed Central
  • Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):144–51. doi:10.1016/j.anai.2019.04.020. Journal
  • Tamagawa-Mineoka R, Katoh N. Atopic dermatitis: identification and management of complicating factors. Int J Mol Sci. 2020;21(8):2671. doi:10.3390/ijms21082671. Journal
  • Torres T, Ferreira EO, Gonçalo M, Mendes-Bastos P, Selores M, Filipe P. Update on atopic dermatitis. Acta Med Port. 2019;32(9):606–13. doi:10.20344/amp.11963. Journal
  • Wang V, Boguniewicz J, Boguniewicz M, Ong PY. The infectious complications of atopic dermatitis. Ann Allergy Asthma Immunol. 2021;126(1):3–12. doi:10.1016/j.anai.2020.08.002. Journal

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