Etiopathogenesis, Clinical Features, and Management of Atopic Dermatitis in Children

Etiology and Pathogenesis

Atopic dermatitis (AD) is a chronic inflammatory skin condition often associated with genetic predisposition, immune dysregulation, and environmental factors. It primarily affects children, causing recurrent episodes of eczematous skin lesions.

Genetic Factors

Mutations in the FLG gene, responsible for encoding filaggrin, lead to an impaired skin barrier, making children susceptible to allergens and irritants.

Immune Dysregulation

AD is characterized by an imbalance between Th1 and Th2 immune responses, with an overactive Th2-mediated inflammation causing excessive IgE production.

Clinical Features

• Pruritus (intense itching)
• Red, inflamed skin patches
• Dry, scaly skin
• Excoriations and secondary infections

Management

Topical Treatments

First-line therapy includes emollients and topical corticosteroids to reduce inflammation.

Systemic Treatments

Severe cases may require systemic immunosuppressants such as cyclosporine or biologics targeting IL-4/IL-13 pathways.

Preventive Strategies

Maintaining skin hydration, avoiding known allergens, and early intervention help in long-term management.