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Atopic eczema - Atopic dermatitis in infants (Pediatrics - PEDS)

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It is a chronic, relapsing inflammatory disease of the skin whose sebaceous glands increase the production of oil. It most frequently affects children under one year of age. It is included in the group of cutaneous eczema. 

There are many different factors that condition its appearance: genetic component, allergic predisposition, infectious cause, psychological cause.

It manifests with reddened, scaly, irritated and itchy areas on the skin, usually on the cheeks, elbows and knees. In many cases, it is associated with skin lesions due to scratching that eventually become infected.

Diagnosis is made by clinical questioning that reveals a previous history of atopy or allergy (including family history) and examination of the lesions.

Outbreaks will be controlled with corticosteroids, antihistamines and immunomodulators. If there is an infection of the area due to scratching, antibiotics can be used.

It is advisable to take care of the skin with mild soap, appropriate creams and avoid sweating. Outbreak triggers should be avoided when known, as well as the smallpox vaccine as a potential risk.  

Bibliographic references
  1. William L Weston, William Howe. Pathogenesis, clinical manifestations, and diagnosis of atopic dermatitis (eczema). UpToDate. Jun 21, 2016.
  2. William L Weston, William Howe. Treatment of atopic dermatitis (eczema). UpToDate. Sep 13, 2016.
  3. 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; 70:338.
  4. Vinding GR, Zarchi K, Ibler KS, et al. Is adult atopic eczema more common than we think? - A population-based study in Danish adults. Acta Derm Venereol 2014; 94:480.
  5. Leslie P. Lawley, Calvin O. McCall y Thomas J. Lawley. Eccema, psoriasis, infecciones cutáneas, acné y otros trastornos cutáneos frecuentes. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición. 344:345
  6. T. Gallart. Enfermedades alérgicas mediadas por anticuerpos IgE (hipersensibilidad inmediata o alerga atópica). Farreras Rozman. Medicina Interna. Volumen 2. 12º edición. 2709:2710.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Lesions don't involve the area around the eyes, mouth and nose

    Lesions on scalp, cheeks, neck, torso and/or limbs

    Hands with lesions on the back

    Skin irritation, which sloughs off

    Reddened skin on the back of the knee, where it bends

Symptoms to watch out for

Fever (temperature higher than 100.4 ºF)
Persistence of symptoms for more than two weeks after initial treatment
Painful and reddened ulcer in affected area
Reddish sores that itch, break open and ooze clear fluid or pus

Self-care

Antihistamines in syrup or tablet form for itching.
Apply a cream or ointment that contains a corticosteroid.
Apply local cold to the injured area 3 times a day to reduce inflammation.
Avoid wearing tight clothing and using perfumed or irritating soaps in the area.
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