Adult-Onset Atopic Dermatitis

  • Jonathan I. Silverberg
    Correspondence
    Corresponding author: Jonathan I. Silverberg, MD, PhD, MPH, Department of Dermatology, Northwestern University Feinberg School of Medicine, Ste 1600, 676 N St Clair St, Chicago, IL 60611.
    Affiliations
    Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Ill

    Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Ill
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      One in 4 adults with atopic dermatitis (AD) report adult-onset disease. Adult-onset AD appears to be associated with a different disease phenotype compared with childhood-onset AD. A broad differential diagnosis must be considered in a patient presenting with an adult-onset eczematous eruption, including allergic contact dermatitis, mycosis fungoides/cutaneous T-cell lymphoma, psoriasis, scabies, and so forth. This review will specifically address the diagnosis, workup, and management of adult-onset AD. In adults presenting a new-onset chronic eczematous eruption, consideration should be given to a diagnosis of adult-onset AD. Patch testing should be performed to rule out allergic contact dermatitis. A biopsy may be obtained to exclude alternative diagnoses, including cutaneous T-cell lymphoma and psoriasis.

      Key words

      Abbreviations used:

      ACD (allergic contact dermatitis), AD (atopic dermatitis), CTCL (cutaneous T-cell lymphoma), H-R (Hanifin and Rajka), SPT (skin prick test)
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