The rash is usually on the flexor surfaces of the extremities, atopic dermatitis can worsen in the presence of allergens like cigarette, smoke, mold and dust mites as well as changes in the weather and even emotional stress, although it usually causes patches of red itchy skin that come and go, the scheme can occasionally even blister and peel over time, the skin can become like Hena fide which literally means turn to leather. Itchiness is often worst at night probably because there are no distractions, this is often when young children are most likely to scratch their eczema lesions because eczema is an autoimmune mediated process, it can’t be spread to other people but since it affects the skin and therefore the way a person looks there’s still a lot of social stigma associated with it. Unfortunately many individuals especially teenagers and young adults with atopic dermatitis suffer from depression and social anxiety as a result, genetics plays an important role in atopic dermatitis and these individuals often also have asthma as well as allergic rhinitis making up what’s called the atopic triad, these illnesses also often run in families occasionally, atopic dermatitis can be part of a syndrome like hyper IgE syndrome which has an autosomal dominant form called Jobe syndrome as well as phenylketonuria which is a metabolic disorder that results from the buildup of the amino acid phenylalanine and wiskott-aldrich syndrome which is an x-linked recessive disease characterized by clinical triad of eczema thrombocytopenia and immunodeficiency. Atopic dermatitis is generally a clinical diagnosis and there are ways to help break the cycle of allergy mediated inflammation, dry skin and itching with regard to allergy mediated inflammation, it’s important to identify and avoid any triggers as well as avoiding overheating, dressing in soft fabrics and managing stress well which is of course a good life habit, anyways dry skin can be managed with frequent moisturization which is usually best to apply after a lukewarm bath and itching can sometimes be managed with simple measures like keeping the fingernails short and trying to keep children from scratching but in more extreme cases there are also steroids and calcineurin inhibitors, both of which aim to dampen the immune reaction as well as antihistamines that can help with itching and antibiotics to help treat infections if they’re needed, all right as a quick recap atopic dermatitis also called atopic eczema is a type 4 hypersensitivity reaction in the skin and is characterized by a cycle of allergy mediated inflammation, dry skin and itching and most commonly affects infants and young children. Atopic dermatitis can be managed by minimizing exposure to allergens, keeping the skin hydrated and minimizing itching.