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Complications of atopic dermatitis

Authors: Dr Amy Stanway, Department of Dermatology, Waikato Hospital, February 2004; Updated: Dr Aysha Rashid, Medical Registrar, Auckland City Hospital, Auckland, New Zealand; Associate Professor Paul Jarrett, Dermatologist, Middlemore Hospital and Department of Medicine, The University of Auckland, Auckland, New Zealand. Copy edited by Gus Mitchell. August 2021


Complications of atopic dermatitis — codes and concepts
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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

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Related information

 

Bibliography

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