Atopic dermatitis and the atopic march

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Target exams

Red flags

• rapidly worsening painful eczema with monomorphic punched-out vesicles suggesting eczema herpeticum
• fever, malaise and systemic upset over an eczematous child
• clusters of umbilicated haemorrhagic vesicles or pustules
• failure to thrive or developmental delay pointing to an immunodeficiency syndrome
• eczema onset in the neonatal period with severe, refractory disease suggesting a primary immunodeficiency
• asymmetric, well-demarcated, scaly plaques suggesting tinea rather than eczema

Life stages

Care settings

Clinical exam formats

Board mappings

• recognise and manage atopic dermatitis in children
• explain the atopic march and its implications
• apply stepwise management and escalate to systemic therapy
• interpret severity scoring and comorbidity risk
• high-yield: diagnostic criteria, barrier pathophysiology, stepwise ladder, eczema herpeticum
• short-case assessment of a child with chronic eczema
• atopic dermatitis — diagnosis, severity assessment and stepwise management
• UK diagnostic criteria, filaggrin and barrier pathophysiology, topical therapy ladder, atopic march
• assess and counsel the parents of a child with eczema
• atopic dermatitis — diagnosis and stepwise management
• atopic dermatitis — milestone: applies diagnostic criteria, initiates stepwise topical therapy, recognises complications
• atopic dermatitis — recognise, assess severity and manage