What is atopic eczema?

This comes from the word ‘atopy’, which refers to a group of
conditions in which the immune system reacts to allergens in the
environment by producing raised levels of immunoglobulin type
E (IgE), which in turn leads to the changes in the skin. Seventy-
five per cent of cases present before the age of 6 months, rising to
90% before the age of 5 years. It is thought to affect 3% of infants
and persists for several years. Of the children affected, 60–70% will
have gone into remission (no longer suffer from eczema) by their
early teenage years, although they remain vulnerable to recurrences
and may always have problems with dry skin. The pattern of rash
on the skin varies with age:
• In infancy, it often starts on the face with vesicles and
weeping. Distribution elsewhere is non-specific, but it does
tend to spare the napkin area.
• As the child ages, the distribution becomes more flexural
around knees, elbows, wrists and ankles. The skin becomes
increasingly thickened, dry and excoriated – often looking
‘leathery’ (lichenification).
This pattern continues into adulthood, with increasing
lichenification and an increasing tendency to affect the trunk,
face and hands.