Authors: Dr Amy Stanway, Department of Dermatology, Waikato (Feb 2004); Updated: Dr Aysha Rashid, Medical Registrar, Auckland; Associate Professor Paul Jarrett, Dermatologist, Middlemore Hospital and Department of Medicine, The University of Auckland, New Zealand (Aug 2021)
Skin infection is very common in atopic dermatitis due to an inherently abnormal skin barrier, cutaneous and systemic immune system abnormalities, and scratching the itch. Cutaneous colonisation by Staphylococcus aureus forms a bacterial biofilm and worsens the dermatitis by promoting the Th2 allergic inflammatory response. Infants are particularly at risk of severe skin infections.
Contact dermatitis should be considered in the atopic patient with an otherwise unexplained dermatitis flare, particularly if in a patterned distribution.
The frequent use of multiple topical treatments for atopic dermatitis increases the risk of allergic contact dermatitis due to exposure to potential allergens.Aeroallergens also commonly aggravate other manifestations of atopy such as hay fever and asthma.
Contact dermatitis to ethylenediamine
Airborne contact dermatitis eyelid
Atopic hand dermatitis
Complications of atopic dermatitis in skin of colour
Boonstra M, Rustemeyer T, Middelkamp-Hup MA. Both children and adult patients with difficult-to-treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized. J Eur Acad Dermatol Venereol. 2018;32(9):1554–61. doi:10.1111/jdv.14973. Journal
Drucker AM. Atopic dermatitis: burden of illness, quality of life, and associated complications. Allergy Asthma Proc. 2017;38(1):3–8. doi:10.2500/aap.2017.38.4005. PubMed
Hsu JI, Pflugfelder SC, Kim SJ. Ocular complications of atopic dermatitis. Cutis. 2019;104(3):189–93. Journal
Jacob SE, McGowan M, Silverberg NB, et al. Pediatric Contact Dermatitis Registry data on contact allergy in children with atopic dermatitis. JAMA Dermatol. 2017;153(8):765–70. doi:10.1001/jamadermatol.2016.6136. PubMed Central
Jeter J, Bowen C. Atopic dermatitis and implications for military service. Mil Med. 2019;184(5-6):e177–82. doi:10.1093/milmed/usy427. Journal
Kim KH. Clinical pearls from atopic dermatitis and its infectious complications. Br J Dermatol. 2014;170 Suppl 1:25–30. doi:10.1111/bjd.12919. Journal
Owen JL, Vakharia PP, Silverberg JI. The role and diagnosis of allergic contact dermatitis in patients with atopic dermatitis. Am J Clin Dermatol. 2018;19(3):293–302. doi:10.1007/s40257-017-0340-7. PubMed Central
Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):144–51. doi:10.1016/j.anai.2019.04.020. Journal
Tamagawa-Mineoka R, Katoh N. Atopic dermatitis: identification and management of complicating factors. Int J Mol Sci. 2020;21(8):2671. doi:10.3390/ijms21082671. Journal
Torres T, Ferreira EO, Gonçalo M, Mendes-Bastos P, Selores M, Filipe P. Update on atopic dermatitis. Acta Med Port. 2019;32(9):606–13. doi:10.20344/amp.11963. Journal
Wang V, Boguniewicz J, Boguniewicz M, Ong PY. The infectious complications of atopic dermatitis. Ann Allergy Asthma Immunol. 2021;126(1):3–12. doi:10.1016/j.anai.2020.08.002. Journal
