Atopic and non-atopic eczema

Introduction

Atopic eczema is a chronic, relapsing, inflammatory skin condition associated with epidermal barrier dysfunction. This article provides a summary of current knowledge on eczema and its management.

Sources and selection criteria

We used the following sources of information to write this review:

• PubMed search using the key words “atopic eczema”, “atopic dermatitis”, “incidence”, “genetics”, “pathogenesis”, “treatment”, and “management”. We gave preference to original articles published in the past three years and recent review articles published in high impact journals

• Search of the following Cochrane Library databases: Cochrane Database of Systemic Reviews; Database of Abstracts and Reviews of Effectiveness; Cochrane Central Register of Controlled Trials

• Personal archive of references.

How do we define atopic eczema?

Atopic eczema and atopic dermatitis are terms that have been used synonymously (for a clinical definition see box), but a review committee by the World Allergy Organisation has published its recommended terminology (see fig 1).1

Eczema is subdivided into atopic and non-atopic eczema because a proportion of patients exhibit eczema without atopic features. Children with atopic eczema are more likely than those with non-atopic eczema to develop asthma later in life, and their eczema more often persists into adulthood. However, atopic and non-atopic eczema have not been shown to respond differently to treatment, and patients with non-atopic eczema may subsequently develop atopic features.