Which physical findings are characteristic of atopic dermatitis (eczema) in childhood?

Updated: Aug 02, 2019
  • Author: Brian S Kim, MD, MTR, FAAD; Chief Editor: William D James, MD  more...
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Xerosis is often generalized. The skin is flaky and rough.

Lichenification is characteristic of childhood AD. It signifies repeated rubbing of the skin and is seen mostly over the folds, bony protuberances, and forehead.

Lesions are eczematous and exudative. Pallor of the face is common; erythema and scaling occur around the eyes. Dennie-Morgan folds (ie, increased folds below the eye) are often seen. Flexural creases, particularly the antecubital and popliteal fossae, and buttock-thigh creases are often affected. See the image below.

Flexural involvement in childhood atopic dermatiti Flexural involvement in childhood atopic dermatitis.

Excoriations and crusting are common. The crusting with AD should not be confused with infection because both may manifest oozing and crusting.

Children with AD are likely to experience symptoms into their teens and beyond. [38, 39, 40]

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