Atopic dermatitis signs & symptoms

Atopic dermatitis is characterized by a non-contagious inflammation of the skin, associated with intense pruritus, which is usually worse at night. AD is one of the most pruriginous (itchy) skin diseases, and pruritus (itchiness) is the first symptom of relapse. In severe cases, patients scratch the areas with AD until bleeding occurs. A common problem in patients with atopic dermatitis is prolonged scratching at night with loss of sleep. 

Patients with atopic dermatitis have significant sleep alterations due to the intense pruritus it causes. These alterations include difficulty to get to sleep, frequently waking up at night, and difficulty to wake up in the morning. Insomnia and decrease in total sleep time lead to drowsiness during the day, tiredness, irritability, decrease in concentration, alterations in growth hormone secretion, and behavioural and discipline problems.

Atopic dermatitis symptoms are recurrent. While some patients have a persistently active chronic condition, some others have symptoms that increase and decrease, alternating between an active disease and periods of remission.

Patients' skin shows red or brownish patches, dry, cracked or squamous skin (table 1). In infants, eczema generally occurs as small bumps on the cheeks, while older children, adolescents and adults usually have rashes on knees or elbows (often in the folds of the joints), on the back of hands or on the scalp (table 2).