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Eczematous Eruptions in Childhood

Atopic dermatitis, one of the most common skin disorders seen in infants and children, is frequently a source of frustration to parents and presents a challenge to immunologists, pediatricians, and dermatologists alike. Affecting approximately 3% of the childhood population, atopic dermatitis frequently causes confusion because the terms eczema and dermatitis are often used synonymously and interchangeably.1 Eczema is a generic term that identifies an acute inflammatory cutaneous eruption characterized by itching, redness, papules, vesicles, edema, serous discharge, and crusting (Fig 1). Dermatitis without a qualifying adjective is less definitive and merely refers to an inflammation of the skin which may result in a spectrum of lesions varying from acute necrosis and ulceration to simple erythema.2 A modifying adjective therefore is frequently added to the general term in an effort to identify the specific eruption under consideration, hence the terms contact dermatitis, seborrheic dermatitis, nummular dermatitis, and atopic dermatitis.
 PATHOGENESIS
 Atopic dermatitis is the most common cause of eczema in children. Although its cause remains unknown, the disorder represents an eczematous disorder of characteristic distribution, a hereditary symptom complex in individuals with paradoxical physiologic responses to pharmacologic stimuli, a constitutional predisposition to develop dry skin and pruritus, and a personal or family history of allergy.