Atopic dermatitis (AD) is a pruritic disease of unknown origin that usually starts in early

infancy, though an adult-onset variant is recognized. That it is the first disease to present in a
series of allergic diseasesincluding food allergy, asthma, and allergic rhinitis, in orderhas
given rise to the atopic march theory, which suggests that AD is part of a progression that
may lead to subsequent allergic disease at other epithelial barrier surfaces.[1, 2] See the image
below.

Flexural involvement in childhood atopic dermatitis.

See All About Allergies: Be Ready for Spring, a Critical Images slideshow, to help identify a
variety of allergens and symptoms.

Essential update: Allergy organization to recommend probiotics in pregnancy

for reduction of pediatric dermatitis
In January 2015, the World Allergy Organization plans to release the first section of the
Guidelines for Allergic Disease Prevention, which will recommend the use of probiotics by
pregnant and lactating women and their breastfed infants to prevent the development of AD.
The recommendation was based on a meta-analysis of 29 studies in which probiotic use by
pregnant women reduced the incidence of eczema by 9% during a 1- to 5-year follow-up
period and use by lactating women was associated with a 16% reduction in eczema during a
6-month follow-up period. Probiotic consumption by breastfeeding infants was associated
with a 5% reduction in eczema during the 6-month to 6-year follow-up period.[3]

Signs and symptoms

Incessant pruritus is the only symptom of AD. The disease typically has an intermittent
course with flares and remissions occurring, often for unexplained reasons.
Primary physical findings include the following: