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Atopic dermatitis is a chronic, relapsing inflammatory skin condition characterized by intense pruritus, eczematous lesions, and skin barrier dysfunction. It typically begins in early childhood and is strongly associated with other atopic diseases including asthma, allergic rhinitis, and food allergies, forming the classic atopic triad.
The condition results from a complex interplay of genetic predisposition (particularly filaggrin mutations), immune dysregulation with predominant Th2 response, and environmental factors. Defective skin barrier function leads to increased transepidermal water loss and enhanced penetration of allergens and irritants, perpetuating the inflammatory cascade and characteristic itch-scratch cycle.
Diagnosis is primarily clinical, based on major criteria including pruritus, typical morphology and distribution (flexural in adults, facial/extensor in infants), chronic/relapsing course, and personal/family history of atopy. Treatment focuses on restoring skin barrier function with emollients, controlling inflammation with topical corticosteroids or calcineurin inhibitors, and identifying/avoiding triggers to prevent flares.