Test Your Knowledge on Atopic Dermatitis
You answered out of 5 questions correctly.
Which of the following statements regarding the diagnosis of atopic dermatitis (AD) is false?
Explanation: The routine use of oral antibiotic therapy to decrease the amount of bacteria on the skin has not been definitively shown to reduce the signs, symptoms (eg, redness or itch), or severity of AD. 1
Which of the following factors contribute to the increased infection risk in AD?
Explanation: Factors that contribute to increased infections in AD are skin barrier defects, suppression of cutaneous innate immunity by type 2 inflammation, Staphylococcus aureus colonization, and cutaneous dysbiosis.2
Which of the following statements regarding treatment of AD during pregnancy is true?
Explanation: Methotrexate for severe AD (used by either the female or male partner) should be discontinued prior to conception. Psoralens plus ultraviolet A (PUVA) should be stopped prior to conception. Orally administered antihistamines should be used to control pruritus. Oral steroids may also be linked to fetal growth restriction, although much of the evidence is in animal studies. 3
Which of the following is true for children 6 months to 6 years of age with severe AD?
Explanation: For children older than 6 months of age with refractory AD, dupilumab therapy should be considered before other forms of conventional immunosuppressive therapy. NBUVB is a more appropriate initial choice than other forms of phototherapy, including UVA1, PUVA, and UVB, for the treatment of severe, refractory AD in children. For children and adolescents with refractory AD for whom dupilumab or phototherapy are inaccessible, undesirable, or ineffective, cyclosporine can be considered.4
Which of the following is true about the presentation of AD in various age groups?
Explanation: In infants and toddlers (<2 years), AD presents with pruritic, red, weeping or scaly, and crusted lesions on the extensor surfaces of limbs and on the trunk, face, and scalp. In older children and adolescents, AD typically presents with lichenified plaques in a flexural distribution, especially of the antecubital and popliteal fossae, volar aspect of the wrists, ankles, and neck. In adults, atopic dermatitis is usually more localized, with predominant lichenification, but exudative forms can also be seen. Chronic hand eczema, facial dermatitis, and eyelid eczema are also frequently seen in adults.5
- Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338-351.
- Wang V, Boguniewicz J, Boguniewicz M, Ong PY. The infectious complications of atopic dermatitis. Ann Allergy Asthma Immunol. 2021;126(1):3-12.
- Weatherhead S, Robson SC, Reynolds NJ. Eczema in pregnancy. BMJ. 2007;335(7611):152-154.
- Yang YB, Gohari A, Lam J. Brief academic review and clinical practice guidelines for pediatric atopic dermatitis. CPR. 2021;17(3):229-237.
- Frazier W, Bhardwaj N. Atopic dermatitis: diagnosis and treatment. Am Fam Physician. 2020;101(10):590-598.