Chronic skin conditions that include itching, redness, and inflammation are described in general terms as “eczema” or “dermatitis.” However, these conditions may be further classified based on other characteristics.
Atopic dermatitis typically begins before age two and is often seen in a patient with a strong family history of allergies. This condition is often seen in conjunction with food allergies and patients with atopic dermatitis are more likely to develop allergic rhinitis and asthma in subsequent years. Diagnosis of atopic dermatitis is made based on the medical history and physical examination of the character and distribution of the dermatitis. Allergy skin testing to select foods and airborne exposures is often employed. Treatment includes avoidance of triggering exposures, aggressive skin moisturization, prescription topical medications, and oral medication, if needed, for itching. A recently approved biologic medication, Dupixent, also may be used for moderate to severe eczema in patients 18 and above.
Contact dermatitis is caused by an irritation or allergic reaction to a substance that comes in direct contact with the skin. This condition is typically seen in older children and adults and can include reactions to poison ivy, metals such as nickel, and cosmetics and chemicals. Contact dermatitis is not necessarily associated with other allergic conditions and can often be diagnosed by patient history and physical exam. Patch testing for contact allergens, most commonly performed by a Dermatologist, may be recommended.