| Summary: | Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the atopic march. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3
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