ATOPIC DERMATITIS

COMPLICATIONS


THINK ABOUT THIS

The patient has developed some raw, oozing spots on her face. These areas have yellowish crusts on top of the usual rash.

What is this common complication and how will you treat it?

Possible Complications of AD
  1. Eye changes can occur and include conjunctivitis, cataracts, and keratoconus. Up to 13% of adults may develop asymptomatic cataracts, both anterior and posterior subcapsular types. In severe AD, keratoconus may develop.

  2. Kaposi's varicelliform eruption is caused by the herpes simplex virus and can be very severe. At one time it carried a high mortality but the use of Acyclovir has changed this.

    To see an image of this complication, click the "Image" button.

    Image

  3. Secondary infection of the skin often involves S. aureus and requires antibiotic treatment.

  4. Type I and IV hypersensitivity reactions to latex may result in anaphylaxis in a few susceptible individuals. It has only been recognized recently as a serious problem in AD. Type I reaction follows exposure to an antigen for which the individual has been previously sensitized. It can result in weakness, dyspnea, itching palms, soles, and scalp, urticaria, hypotension, and circulatory collapse. Type IV reactions are delayed sensitivity reactions, e.g., skin testing, contact dermatitis, graft vs host reactions.


STOP!

Review Questions

  1. What is the most common complication of AD?

  2. What is the most serious complication and why?

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