REVIEW   

Giornale Italiano di Dermatologia e Venereologia 2019 August;154(4):425-34

DOI: 10.23736/S0392-0488.18.06236-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Contact dermatitis and atopic dermatitis: two tales, an interwoven story

G. Alden HOLMES ¹, Janna M. VASSANTACHART ², Calvin T. SUNG ³, Alina GOLDENBERG ⁴, Sharon E. JACOB ⁵ ✉

¹ Riverside Community Hospital, University of California Riverside School of Medicine, Riverside, CA, USA; ² Loma Linda University, Loma Linda, CA, USA; ³ University of California Riverside School of Medicine, University of California, Riverside, CA, USA; ⁴ University of California - San Diego, La Jolla, CA, USA; ⁵ Department of Dermatology, Loma Linda University, Loma Linda, CA, USA

Atopic dermatitis is a multifactorial disease that can concomitantly occur with irritant or allergic contact dermatitis. The colloquial use of atopic dermatitis and eczema interchangeably has created confusion among patients and providers alike. Atopic skin is a complex entity that involves a defective barrier and biome, an aberrant immune response, and abnormal neural activation, while eczema is a generalized term denoting a particular appearance common to multiple diagnoses including atopic dermatitis and contact dermatitis. The conventional paradigm that simplifies atopic dermatitis and allergic contact dermatitis into distinct Th2 and Th1 processes, respectively, fails to acknowledge potential immunologic intersection points and contributes to impaired disease management. This article will review the complex interplay of atopic dermatitis and contact dermatitis and discuss treatment strategies for recalcitrant cases.

KEY WORDS: Allergic contact dermatitis; Atopic dermatitis; Irritant dermatitis