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ADULT ATOPIC DERMATITIS/ECZEMA
Similar to childhood phase with added pigmentation changes (darkening of the skin) around the neck region.
The most severely affected patients may also present facial redness due to erythema (flushing due to the dilation of the blood vessels in the dermis). Erythema may be due to the inflammation associated with the condition or to a secondary infection. The erythema may be itchy and is usually on a background of "lichenification" (thickening of the skin). It also may spread to the upper chest, arms and back.
The condition frequently presents on areas that sweat. Reddening of the lips and the surrounding area and pigmentation (darkening) around the eye region is common.
Photosensitivity is also common and may cause exacerbation of the condition in areas exposed to sunlight. Thus seasonal variation is very common.
Another common presentation is patchy hand dermatitis/eczema with chronic lichenification of the hands, especially in patients whose occupation continually exposes them to trigger factors (e.g. those working with chemical cleaners).
Of the 50% of children who develop Atopic dermatitis/eczema, 50 % of these are usually “clear” of the condition by the age of 13. It is extremely unusual for a typical case of this condition to present for the first time in adulthood, with less than 2% presenting after the age of 20. This is usually associated with a patient being constantly exposed to chemical irritants late in life.
By the age of 30 most atopic dermatitis/eczema patients are usually “Clear” but it must be remembered that the patient will remain “sensitive” for life as they have agenetic predisposition to the condition. Even if a person has been “clear” for many years this condition can flare up if the patient is exposured to a “new” set of irritants.
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