This article explains the symptoms of atopic dermatitis, including symptoms affecting different body parts.

<Things you should know> Correct knowledge about "Atopic Dermatitis" (1) Explanation of the symptoms of "Atopic Dermatitis" and symptoms by affected area

Atopic dermatitis is characterized by intense itching. Scratching weakens the skin's barrier function, worsening the symptoms of dermatitis. It often begins at 2-3 months of age, worsens during childhood and school age, and improves in adulthood, although some people develop it for the first time in adulthood. This article, supervised by a dermatologist, explains the general symptoms of atopic dermatitis and symptoms in different areas.

Main causes of atopic dermatitis

Main causes of atopic dermatitis​

Why does atopic dermatitis develop? Let's start by reviewing the definition of atopic dermatitis and then explore its causes.

What is atopic dermatitis?

The "atopy" in atopic dermatitis means "mysterious disease." It is characterized by severely itchy eczema that repeatedly worsens and improves. It is known that people who have a family history of atopic dermatitis, bronchial asthma, allergic rhinitis, or conjunctivitis, or who have a naturally weak skin barrier function, are more prone to developing atopic dermatitis.

According to the 2014 "Patient Survey" conducted by the Ministry of Health, Labour and Welfare, the total number of patients with atopic dermatitis is estimated at 456,000. When the disease develops, it causes itchy redness and bumpy rashes. Another characteristic of atopic dermatitis is that the entire skin becomes dry and flaky. These symptoms worsen when the skin is scratched.

Main causes of onset

The exact mechanisms behind the development of atopic dermatitis are not fully understood. Besides an allergic predisposition, genetic factors and innate constitution, such as dry skin and a weakened skin barrier function, are considered contributing factors.
When a condition is caused by factors after birth rather than being present from birth, it is called "acquired." The following are some examples of acquired factors that can worsen atopic dermatitis.

cause
  • Dust mites
  • House dust
  • pollen
  • dry
  • sweat
  • bacteria
  • clothing

It is believed that atopic dermatitis worsens when factors such as house dust and mite allergens, as well as irritants like sweat, are added to the existing condition. Regarding clothing, for example, direct contact with functional underwear can also worsen dermatitis.

Main symptoms of atopic dermatitis

​Main symptoms of atopic dermatitis

What symptoms appear when someone develops atopic dermatitis? Let's take a closer look at the stages of symptoms and the areas most prone to developing the condition.

Stepwise symptoms

In children, dry skin is often observed in the early stages. In atopic dry skin, symptoms such as redness and bumps are seen mainly on the inside of the joints.

The skin becomes dry and rough to the touch, resembling goosebumps. Scratching itchy skin can also cause it to become rough and thickened.

Adults may experience similar symptoms to children, and facial symptoms tend to be more difficult to treat. Furthermore, the condition can worsen, potentially leading to erythroderma, a condition where the entire body becomes red, and can become severe.

Main areas where it is most likely to occur

It is particularly common to develop in areas that are prone to friction or irritation from clothing, such as the inside of the elbow and knee joints and the neck. It is also not uncommon to see it on the face.

Atopic dermatitis in adults is on the rise!?

Atopic dermatitis in adults is on the rise!?

As mentioned earlier, atopic dermatitis can also occur in adults.

In some cases, atopic dermatitis that developed in childhood persists, but others experience relapses after being cured, and some develop it for the first time in adulthood. Symptoms include thickening of the skin (lichenification) and prominent bumps (prurigo), and the itching becomes very intense, often leading to scratching and worsening of the condition.

Symptoms of worsening (severe) atopic dermatitis

Atopic dermatitis becomes more difficult to treat when symptoms worsen. Let's look at the specific symptoms that occur when the condition worsens, and the causes that lead to these worsening symptoms.

Symptoms of worsening (severe) atopic dermatitis

Symptoms of worsening condition

While atopic dermatitis in childhood often resolves naturally over time, symptoms can sometimes persist into adolescence and adulthood. Because worsening of the condition can prolong the symptoms, early intervention is crucial.

My condition fluctuates with the seasons, sometimes getting better and sometimes worse. It tends to worsen especially in winter and early spring when the air is dry, as well as in summer when sweating exacerbates the symptoms.

In both children and adults, scratching the skin can worsen dermatitis symptoms and create a vicious cycle of increasing itchiness.

Main factors that worsen the condition

In many cases, atopic dermatitis worsens due to the allergic reaction itself. Another contributing factor is skin irritation. Severe scratching not only damages the skin but also further weakens its barrier function, making it more susceptible to irritation. When allergic factors, dryness, sweat, lack of sleep, and other acquired aggravating factors combine, inflammation occurs, leading to a vicious cycle where symptoms worsen even more.

​Skin diseases similar to atopic dermatitis

There are also skin conditions that have symptoms similar to atopic dermatitis, such as eczema and itching. Let's look at some of the main ones.

  • contact dermatitis

    Dermatitis caused by substances that come into contact with the skin from the outside. It is divided into two types: irritant dermatitis and allergic dermatitis.

  • seborrheic dermatitis

    This disease appears in areas with active sebum secretion, such as the face, head, armpits, and genitals. It presents as reddish rashes on dry, flaky skin. It can be particularly difficult to distinguish from facial atopic dermatitis.

  • Prurigo simplex

    These are bumpy, itchy bumps that appear on the hands and feet. They can also be caused by scratching insect bites.

  • Scabies

    This is an infectious disease caused by the Sarcoptes scabiei mite, which parasitizes humans. It is accompanied by severe itching. Sometimes, even dermatologists find it difficult to differentiate it from atopic dermatitis.

  • heat rash

    These skin lesions appear when you sweat a lot and are itchy. They are commonly found in areas where sweat tends to accumulate, such as the inside of the knees and elbows.

  • Seborrheic dermatitis

    This condition occurs when the skin's ability to retain moisture decreases, leading to dry skin known as xerosis. When external stimuli are applied to this weakened skin barrier, eczema can appear secondarily.

  • hand eczema

    This refers to eczema or dermatitis that appears on the palms, backs of the hands, and fingers.

  • Psoriasis

    This disease is primarily characterized by inflammation and keratinization (hardening). The skin appears red and covered with layers of silvery-white keratin.

These skin conditions can also occur in conjunction with atopic dermatitis.

Commonly occurring co-occurring diseases and important complications

Commonly occurring co-occurring diseases and important complications

Atopic dermatitis is characterized by an allergic predisposition and a disruption of the skin's barrier function, which can lead to several co-occurring illnesses and complications. Let's take a look at each of them.

Diseases that often occur together

  • Bronchial asthma

    This disorder is characterized by sudden coughing and phlegm production, as well as shortness of breath accompanied by wheezing or whistling sounds during breathing. It is believed to be caused by chronic inflammation of the airways, which makes them sensitive to various stimuli. In children, atopic reactions to allergens, including inhaled allergens (such as dust mites, pets, and mold), are frequently the cause.

  • Allergic rhinitis

    Allergic rhinitis is a disease characterized by symptoms such as sneezing, runny nose (watery), and nasal congestion. It is classified into perennial allergic rhinitis, caused by dust mites and house dust, and seasonal allergic rhinitis, caused by cedar, cypress, timothy grass, ragweed, birch, and other pollen species.

  • Allergic conjunctivitis

    If you experience symptoms such as inflammation and redness of the white part of the eye (conjunctiva), itching, discharge, and tearing, you may be diagnosed with an allergic conjunctival disease. In particular, chronic allergic conjunctival disease that occurs in people with atopic dermatitis on their face is sometimes called atopic keratoconjunctivitis.

  • Springtime Catalonia

    This refers to a severe form of allergic conjunctivitis that occurs from spring to summer. It can be accompanied by serious corneal damage such as punctate superficial keratopathy, corneal erosion, ulcers, corneal opacity, and vascular invasion. Eyelid dermatitis may also be persistent.

Important complications

  • cataract

    This is a disease in which the lens at the front of the eyeball becomes cloudy. It is more likely to develop with age, and is therefore considered one of the signs of aging.

  • Retinal detachment

    This disease involves the retina, the most important part of the eye, becoming detached for some reason. Various symptoms can appear, such as seeing black spots or insect-like shapes, vision loss, or decreased visual acuity.

  • Kaposi's varicelliform eruption

    It occurs when the herpes virus infects skin with a weakened barrier function due to atopic dermatitis. Sometimes it can cause a high fever and may require hospitalization.

  • Molluscum contagiosum

    This is commonly known as "water warts," a skin infection caused by the molluscum contagiosum virus. It is frequently seen in children.

  • Impetigo

    This is a disease caused by bacterial infection, commonly known as impetigo. It is more common in children and is frequently seen during the summer months. Oral and topical antibiotics are necessary.

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Professor Tokuya Omi
Supervised by: Professor Tokuya Omi
Graduated from Nippon Medical School Graduate School. Visiting Research Professor at Aarhus University and Visiting Professor at Nippon Medical School. Certified Specialist in Cosmetic Dermatology and Laser Treatment by the Japanese Dermatological Association. Certified Specialist in Dermatology by the Japanese Dermatological Association. Certified Specialist in Allergology by the Japanese Society of Allergology.

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