The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors.
Children are more likely to develop this disorder if one or both parents have had it or have had allergic conditions like asthma or hay fever. While some people outgrow skin symptoms, approximately three-fourths of children with atopic dermatitis go on to develop hay fever or asthma.
Environmental factors can bring on symptoms of atopic dermatitis at any time in individuals who have inherited the atopic disease trait.
Atopic dermatitis is also associated with malfunction of the body’s immune system: the system that recognizes and helps fight bacteria and viruses that invade the body.
Scientists have found that people with atopic dermatitis have a low level of a cytokine (a protein) that is essential to the healthy function of the body’s immune system and a high level of other cytokines that lead to allergic reactions. The immune system can become misguided and create inflammation in the skin even in the absence of a major infection. This can be viewed as a form of autoimmunity, where a body reacts against its own tissues.
In the past, doctors thought that atopic dermatitis was caused by an emotional disorder. We now know that emotional factors, such as stress, can make the condition worse, but they do not cause the disease.
Skin Features Associated With Atopic Dermatitis
Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
Cheilitis: inflammation of the skin on and around the lips
Hyperlinear palms: increased number of skin creases on the palms
Hyperpigmented eyelids: eyelids that have become darker in color from inflammation or hay fever
Ichthyosis: dry, rectangular scales on the skin
Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs
Lichenification: thick, leathery skin resulting from constant scratching and rubbing
Papules: small raised bumps that may open when scratched and become crusty and infected
Urticaria: hives (red, raised bumps) that may occur after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath
Revision date: July 5, 2011
Last revised: by Janet A. Staessen, MD, PhD