Clinical aspects of atopic dermatitis

Atopic dermatitis (AD), or atopic eczema, is the most common, chronic infla mmatory disease among children in industrialized countries. We still lack k nowledge of its pathophysiology and in particular the role of allergy as bo th an eliciting factor for disease expression and for disease activity. Thi s article describes the clinical symptoms of the disease and its qualitativ ely different aspects. AD cannot be understood as being induced by one fact or only, e.g. allergy, and this is important when planning treatment strate gies. It is also important to realize the very wide range of disease intens ity: from subclinical, or latent AD, in which only a few symptoms are prese nt and thus which prevents a clear diagnosis of AD, to its most severe form s including erythroderma. It's unknown aetiology, the wide range in symptom atology, and the fluctuating course (including the many eliciting factors) form the background for our diagnostic and therapeutic difficulties of atop ic eczema. AD is prevalent in childhood, but the atopic trait continues, no t only for later respiratory allergies, but also for skin diseases in adult hood (such as AD itself or the frequent irritant contact dermatitis of the hands). A child with an acute and first attack of AD is therefore a challen ge to the child, its parents and - certainly - to the doctor. However, afte r stressing the chronicity of the disease, it is equally important to assur e the parents that this disease is, in most cases, controllable through cor rect treatment and that it has a good prognosis: It is not a 'life sentence ', but a controllable disease in an otherwise healthy child.