Atopic dermatitis differential diagnosis: Difference between revisions

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* keratinocyte hyperproliferation
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* dysregulation of the immune system
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Revision as of 14:02, 16 October 2018

Atopic dermatitis Microchapters

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Differentiating Atopic dermatitis from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Differentiating Atopic Dermatitis from other Diseases

Category Diseases Etiology Inherited Acquired Clinical manifestations Para-clinical findings Gold standard Additional findings
Demography History Symptoms Physical examination
Lab Findings Imaging Histopathology
Appearance Itching Bleeding Fever BP Tenderness Nail pitting Other CBC ESR/CRP Electrolytes BUN/Cr LFT
Single/

Multiple

Rash Involved areas Pustule WBC Hb Plt
Skin disorders Atopic dermatitis
  • Hayfever
  • Asthma
Allergic contact dermatitis[1]
  • Delayed-type hypersensitivity response
  • Skin inflammation mediated by hapten-specific T cells
+ Any
  • Contact with allergens in the past 1-2 days
  • Positive family history
May be multiple after 1-2 days of exposure Erythematous well-demarcated papules Surrounding the area in contact with the offending agent + Nl +
  • Stinging and burning
  • Localized swelling
  • Lichenified pruritic plaques
Nl to ↑

(Eosinophilia)

Nl Nl Nl Nl Nl Nl NA NA Clinical manifestation + patch test
  • Prevention by avoidance
Irritant contact dermatitis[2]
  • Activation of the innate immune system by the pro-inflammatory properties of chemicals
+ Any, more occupational exposure
  • Cumulative exposure to irritants
Usually single immediately after the exposure Well-demarcated red patch with a glazed surface Any area in contact with the irritant + Nl +
  • Swelling, blistering and scaling of the damaged area
  • Dryness
  • Thicker skin
Nl Nl Nl Nl Nl Nl Nl NA
  • Spongiosis
  • Intraepidermal vesicles or bullae
  • Necrosis of keratinocytes
Clinical manifestation + patch test
  • Negative hypersensitivity tests
Seborrheic dermatitis
  • Unknown
+ Any, onset during the 1st days or weeks of life
  • Stress
  • Cold, dry weather
Greasy scaling on a yellow-red base Scalp, axilla, and diaper area
Psoriasis
  • keratinocyte hyperproliferation
  • dysregulation of the immune system
+
Lichen simplex chronicus
Ichthyosis vulgaris
Nummular dermatitis
Netherton's syndrome
Dubowitz syndrome
Erythrokeratodermia variabilis
Diseases Etiology Inherited Acquired Demography History Single/

Multiple

Rash Involved areas Pustule Itching Bleeding Fever BP Tenderness Nail pitting Other WBC Hb Plt ESR/CRP Electrolytes BUN/Cr LFT Imaging Histopathology Gold standard Additional findings
Infection Dermatophytes
Candida
Herpes simplex
Staphylococcus aureus
Molluscum contagiosum
Scabies
  • Positive family history
Multiple Erythematous papular lesions Flexor wrists, finger webs and genitalia +++
HIV
Diseases Etiology Inherited Acquired Demography History Single/

Multiple

Rash Involved areas Pustule Itching Bleeding Fever BP Tenderness Nail pitting Other WBC Hb Plt ESR/CRP Electrolytes BUN/Cr LFT Imaging Histopathology Gold standard Additional findings
Immunologic disorders Dermatitis herpetiformis
Pemphigus foliaceus
Graft-versus-host disease
Dermatomyositis
Immune deficiency Wiskott-Aldrich syndrome
Hyper-IgE syndrome
DiGeorge syndrome
Severe combined immunodeficiency (SCID)
Ataxia telangiectasia
Diseases Etiology Inherited Acquired Demography History Single/

Multiple

Rash Involved areas Pustule Itching Bleeding Fever BP Tenderness Nail pitting Other WBC Hb Plt ESR/CRP Electrolytes BUN/Cr LFT Imaging Histopathology Gold standard Additional findings
Metabolic Diseases Phenylketonuria
Tyrosinemia
Histidinemia
Multiple carboxylase deficiency
Nutritional deficiencies Zinc deficiency
Niacin (B3) deficiency
Pyridoxine (B6) deficiency
Biotin (B7) deficiency
Malignancy Mycosis fungoides
Histiocytosis X
Medications Infliximab
Category Diseases Etiology Inherited Acquired Demography History Single/

Multiple

Rash Involved areas Pustule Itching Bleeding Fever BP Tenderness Nail pitting Other WBC Hb Plt ESR/CRP Electrolytes BUN/Cr LFT Imaging Histopathology Gold standard Additional findings

References

  1. Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas JF (2009). "Allergic and irritant contact dermatitis". Eur J Dermatol. 19 (4): 325–32. doi:10.1684/ejd.2009.0686. PMID 19447733.
  2. Bains SN, Nash P, Fonacier L (October 2018). "Irritant Contact Dermatitis". Clin Rev Allergy Immunol. doi:10.1007/s12016-018-8713-0. PMID 30293200.


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