Page 45 - LECTURE NOTES

B. facial and extensor involvement in children

3. chronic or chronically relapsing dermatitis
4. personal or family history of atopic diseases (asthma , allergic rhinitis, allergic

conjunctivitis and atopic eczema )
Minor Criteria One Must Have Three of the Following

9 Dryness of the skin (xerosis, xeroderma)
9 Ichthiosis/hyperlinear palms and soles

9 IgE reactivity

9 Elevated serum IgE
9 Early stage of onset

9 Tendency to cutaneous infection

9 Pityriasis alba
9 Itching when sweating

9 Intolerance to wool and lipid solvents perifollicular accentuation

For young infants the diagnostic criteria is modified
™ The three major criterias are

1. family history of atopic diseases

2. Typical facial or extensor dermatitis
3. Evidence of pruritus

™ Three minor features are:
ƒ Xerosis/ ichthiosis / hyperlinearity of palms and soles

ƒ Perifollicular accentuation
ƒ Post auricular fissure

ƒ Chronic scalp scaling

The hall mark of atopic eczema is pruritus and dryness of the skin. Long standing
pruritus results in lichenified dry skin which would call for further scratching and in this

way the itch -scratch cycle establishes which assumes a vicious form. The flexures like

the popilitial fossa, wrist, and anticubital fossa are affected.
The pattern of distribution in atopic eczemas depends on the age and activity of the

disease. Based on that atopic eczemas are classified in to: infantile eczema (from 2

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