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Eczema/Atopic Dermatitis, Emergency Medicine

James A. Nelson Reviewed 06/2017



  • Atopic dermatitis is the most common cause of eczema and the terms are often used synonymously.

    • Associated with allergic diseases such as asthma and allergic rhinitis

  • Eczema literally ...


Signs and Symptoms


  • Rash, pruritus, and atopy traditionally prompt the diagnosis

  • UK diagnostic criteria = pruritus and 3 of the following:

    • Flexural distribution

    • Atopic history (asthma or a...


Ed Treatment/Procedures

  • Mild disease or disease of the head and neck:

    • Low-potency corticosteroids such as hydrocortisone 1–2.5%

    • Eucerin cream: Apply to affected areas BID

  • Moderate or severe dise...



Issues for Referral

Dermatology referral for problematic cases 

Follow-Up Recommendations

  • Patients should be warned of adverse consequences of treatment:

    • High-potency steroids can cau...

Pearls and Pitfalls

  • Consider secondary cellulitis, as 90% of patients with atopic dermatitis are eventually colonized with S. aureus

  • Use tacrolimus and pimecrolimus for moderate to severe disease of th...

Additional Reading

  • Beltrani  VS. Suggestions regarding a more appropriate understanding of atopic dermatitis. Curr Opin Allergy Clin Immunol.  2005;5:413–418.

  • Bieber  T. Atopic dermatitis. N Engl ...



  • 691.8 Other atopic dermatitis and related conditions

  • 692.9 Contact dermatitis and other eczema, unspecified cause


  • L20.9 Atopic dermatitis, unspecified

  • L20.82 Flexural eczema

  • L30.9 Dermatiti...

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