eMedicine Specialties > Ophthalmology > Dermatologic Disorders

Dermatitis, Atopic: Differential Diagnoses & Workup

Author: R Scott Lowery, MD, Assistant Professor of Ophthalmology, Department of Pediatric Ophthalmology and Strabismus, University of Arkansas for Medical Center, Arkansas Children's Hospital
Contributor Information and Disclosures

Updated: Apr 10, 2009

Differential Diagnoses

Conjunctivitis, Acute Hemorrhagic
Keratoconjunctivitis, Atopic
Conjunctivitis, Allergic
Keratoconus
Conjunctivitis, Bacterial
Ocular Rosacea
Conjunctivitis, Giant Papillary
Red Eye Evaluation
Conjunctivitis, Neonatal
Conjunctivitis, Viral

Workup

Laboratory Studies

  • Diagnosis of atopic dermatitis is usually a clinical one based on history and physical findings.
  • Laboratory tests that may be of use early in the diagnostic process include various types of skin testing and serum testing for elevated immunoglobulin E (IgE).
  • Patients with atopic dermatitis display immediate skin test reactivity and may display skin blanching to cholinergic agents.
  • Culture of eyes with conjunctivitis associated with atopic dermatitis usually grows Staphylococcus aureus.
  • Once a clinical diagnosis of atopic dermatitis has been established, lab testing is generally unnecessary.

Histologic Findings

Examination of histopathologic sections early in the disease process shows parakeratosis, hyperkeratosis, acanthosis, intercellular and intracellular fluid accumulation, and perivascular infiltration of the dermis and epidermis by lymphocytes, monocytes, and macrophages. Later in the disease, observation reveals hyperkeratosis, dyskeratosis, acanthosis, and a thickened epidermis. Lysosomes have been demonstrated by electron microscopy.

More on Dermatitis, Atopic

Overview: Dermatitis, Atopic
Differential Diagnoses & Workup: Dermatitis, Atopic
Treatment & Medication: Dermatitis, Atopic
Follow-up: Dermatitis, Atopic
References
Further Reading
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References

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Keywords

atopic dermatitis, atopic eczema, Besnier prurigo, prurigo Besnier, Besnier's prurigo, atopy

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Contributor Information and Disclosures

Author

R Scott Lowery, MD, Assistant Professor of Ophthalmology, Department of Pediatric Ophthalmology and Strabismus, University of Arkansas for Medical Center, Arkansas Children's Hospital
R Scott Lowery, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Jack L Wilson, PhD, Distinguished Professor, Department of Anatomy and Neurobiology, University of Tennessee at Memphis
Jack L Wilson, PhD is a member of the following medical societies: American Association of Anatomists, American Association of Clinical Anatomists, and American Heart Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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