Newer Concepts of Atopic Dermatitis

Abstract

Atopic dermatitis is a disease of fascination and frustration to medical practitioners and researchers. This very common disorder is confusing from several standpoints. The confusion begins with nomenclature; in discussions with American nondermatologic physicians, we might hear atopic dermatitis referred to as "eczema," allergic dermatitis, allergic eczema, or even neurodermatitis. Many Europeans continue to use the term prurigo Besnier. Diagnostic features of atopic dermatitis are another source of confusion. The skin lesions a pediatrician sees on a child's skin may be vastly different from the lesions the general practitioner sees on that same individual 15 years later. There may be no single distinguishing characteristic; diagnosis may depend on a combination of morphologic, distributional, and historical features. Histological findings provide very little aid in diagnosis, though a recent preliminary report by Mihm et al¹raises the hope that new histologic techniques may reveal distinct histopathologic features in atopic dermatitis. With