How is it Diagnosed?
Atopic Dermatitis (AD), also known as eczema, is a chronic, relapsing inflammatory skin
condition commonly seen in children but also affecting adults. Diagnosis is primarily
clinical, based on characteristic features and history.
Patients usually present with intensely itchy, dry, red, and scaly skin, often affecting
flexural areas like the elbows, knees, neck, and face in infants. Chronic scratching leads
to lichenification and excoriations. The condition tends to flare periodically.
History of personal or family atopy (asthma, allergic rhinitis, or AD) strengthens the
diagnosis. Symptoms may be worsened by irritants, weather, allergens, or stress. The
age of onset (usually before age 5) is also a key diagnostic clue.
There are no specific laboratory tests to confirm AD, but certain investigations may
support the diagnosis:
- Serum IgE levels – often elevated in moderate to severe cases
- Skin prick testing – to detect allergic triggers
- Patch testing – to rule out allergic contact dermatitis
- Skin biopsy is rarely needed but may be done in atypical or treatment-resistant cases
to exclude other dermatoses like psoriasis or cutaneous lymphoma.
- Diagnosis is based on criteria such as those proposed by Hanifin and Rajka, which
include major (pruritus, chronic relapsing course, typical distribution, personal/family
atopy) and minor features.
- Early diagnosis allows for prompt management with moisturizers, topical
corticosteroids, antihistamines, and avoidance of triggers, thus reducing flare-ups and
improving quality of life.