Atopic dermatitis and the atopic march

Overview & Definition

A baby who sleeps badly, scratches until the cheeks weep, and develops crusted red plaques on the extensor surfaces of the arms is the everyday face of atopic dermatitis in primary care. The disease is a chronic, intensely itchy, relapsing inflammatory skin disorder that begins in infancy in most children and follows a fluctuating course of flares and remissions, driven by a defective epidermal barrier and a Th2-skewed immune response. [1]

Atopic dermatitis is the most common chronic skin disease of childhood, affecting up to one in five children worldwide, and it is the first and most frequent manifestation of atopy. The term atopic march describes the typical temporal progression from atopic dermatitis and food allergy in infancy to allergic rhinitis and asthma through the preschool and school-age years, reflecting how a single barrier-and-immune defect can seed disease across multiple organ systems. [2]

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