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What is atopic skin disease?

publication date: Apr 7, 2011
author/source: DrB
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Atopy is a condition a person is born with: it is constitutional.

Atopy carries with it a possibility of getting asthma, hay fever, and eczema.
The Atopic Triad
Eczema and dermatitis are terms that can be used interchangeably for a particular type of skin inflammation. It occurs with atopy, and also without: when it occurs with atopy it is called atopic.
Atopic skin disease is a term that is also used interchangeably with atopic eczema and atopic dermatitis.
Atopic eczema appears differently at different ages, but a striking behavioural characteristic throughout is scratching. Scratching of the skin begins as a reflex response to the itch of eczema.
In one of the earliest descriptions of atopic eczema, the French physician Ernest Besnier (1831-1909) called it simply "the itch", or prurigo.

Synonymous terms

Scratching  is a behaviour that is initially a reflex response to the itching  of eczema. Over time any behaviour that is repeated sufficiently can become an automatic habit, and can become linked to circumstances, which then can trigger the behaviour - in this case habitual scratching.

Any skin that is repetitively scratched over time becomes thickened, an appearance called lichenification.

Typical lichenification with excoriation of the wrist in atopic eczema

The term atopic skin disease is used to emphasize this non-specific characteristic complication of chronic atopic eczema, a complication that is relatively resistant to topical treatment on its own. The Combined Approach therefore adds behaviour modification to topical treatment for successful results.  

Atopic Skin Disease is the same as atopic eczema and atopic dermatitis. Atopic skin disease is preferred when emphasizing the characteristic but non-specific complication lichenification - skin thickening - due to habitual scratching.