disseminated neurodermatitis


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atopic dermatitis

A chronic immune-mediated dermatopathy affecting 1–3% of children, which is characterised by severe pruritus of early (usually in infancy) onset and a familial tendency; it may be associated with IgE-mediated skin reactions, allergic rhinitis and/or asthma.

Aetiology
Idiopathic in children; in adults, hypersensitivity to chemicals (e.g., detergents or soaps), metals (e.g., nickel) or plants (e.g., poison ivy, poison oak).
 
Clinical findings
In infancy, atopic dermatitis tends to be weeping, papulovesicular (which rupture and ooze) and intensely pruritic inflammation of cheeks and inguinal region; in later childhood, it is more lichenified and is more prevalent over antecubital, popliteal and collar regions.
 
Exacerbating factors
Anxiety, stress, depression.
 
Lab
Eosinophilia.
 
Management
• Control pruritus (antihistamines, prevent scratching); 
• Identify/avoid allergens (e.g., milk, eggs, wheat, peanuts, legumes, fish); 
• Anti-inflammatories (especially corticosteroids);
• Keratolytics to manage lichenification; 
• Topical immunosuppressants (e.g., topical tacrolimus/FK-506 ointment).

disseminated neurodermatitis

Chronic superficial inflammation of the skin characterized by thickening, excoriation, and lichenification, usually beginning in infancy. It is common in families with a high incidence of allergic diseases.
Synonym: atopic dermatitis
See also: neurodermatitis
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