Ophthalmologic Manifestations of Atopic Dermatitis Workup

  • Author: R Scott Lowery, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 14, 2012
 

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.
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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.

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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 Sciences College of Medicine, Arkansas Children's Hospital

R Scott Lowery, MD is a member of the following medical societies: American Academy of Ophthalmology and Arkansas Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Jack L Wilson, PhD  Distinguished Professor, Department of Anatomy and Neurobiology, University of Tennessee Health Science Center College of Medicine

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.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

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.

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director 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; RPS Ownership interest Other; EyeGate Pharma Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting; Merck Honoraria Speaking and teaching

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.

References
  1. Rapoza PA, Chandler JW. Atopic dermatitis. In: Weingeist T, Gould D, eds. The Eye in Systemic Disease. Philadelphia: Lippincott; 1990:606-609.

  2. Shen CP, Xing H, Ma L. [Research advances in atopic dermatitis]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Feb 2009;31(1):103-6. [Medline].

  3. Jung T, Stingl G. Atopic dermatitis: therapeutic concepts evolving from new pathophysiologic insights. J Allergy Clin Immunol. Dec 2008;122(6):1074-81. [Medline].

  4. Bezan DJ. Eye itch. In: Bezan DJ, Larussa FP, Nishimoto JH, et al, eds. Differential Diagnosis in Primary Eye Care. Boston: Butterworth-Heinemann; 1999:67-71.

  5. Brenninkmeijer EE, Legierse CM, Sillevis Smitt JH, Last BF, Grootenhuis MA, Bos JD. The course of life of patients with childhood atopic dermatitis. Pediatr Dermatol. Jan-Feb 2009;26(1):14-22. [Medline].

  6. Bielory B, Bielory L. Atopic dermatitis and keratoconjunctivitis. Immunol Allergy Clin North Am. Aug 2010;30(3):323-36. [Medline].

  7. Cornish KS, Gregory ME, Ramaesh K. Systemic cyclosporin A in severe atopic keratoconjunctivitis. Eur J Ophthalmol. Sep-Oct 2010;20(5):844-51. [Medline].

  8. Anderson PC, Dinulos JG. Atopic dermatitis and alternative management strategies. Curr Opin Pediatr. Feb 2009;21(1):131-8. [Medline].

  9. Ricci G, Dondi A, Patrizi A, Masi M. Systemic therapy of atopic dermatitis in children. Drugs. 2009;69(3):297-306. [Medline].

  10. Kaujalgi R, Handa S, Jain A, Kanwar AJ. Ocular abnormalities in atopic dermatitis in Indian patients. Indian J Dermatol Venereol Leprol. Mar-Apr 2009;75(2):148-51. [Medline].

  11. Clark RAF, Kristal L. Atopic dermatitis. In: Sams J, Lynch PJ, eds. Principles and Practice of Dermatology. 2nd ed. New York: Churchill Livingstone Inc; 1996:403-418.

  12. Friedlander MH. Diseases affecting the eye and the skin. In: Allergy and Immunology of the Eye. 2nd ed. 1993:75-106.

  13. Friedlander MH. Atopic dermatitis. In: Current Ocular Therapy. 5th ed. Philadelphia: WB Saunders Co; 2000:143-144.

  14. Furue M, Terao H, Moroi Y, et al. Dosage and adverse effects of topical tacrolimus and steroids in daily management of atopic dermatitis. J Dermatol. Apr 2004;31(4):277-83. [Medline].

  15. Guin JD. Eyelid dermatitis: experience in 203 cases. J Am Acad Dermatol. Nov 2002;47(5):755-65. [Medline].

  16. Hanifin JM. Atopic dermatitis: broadening the perspective. J Am Acad Dermatol. Jul 2004;51(1 Suppl):S23-4. [Medline].

  17. Kanski JJ. Disorders of the conjunctiva. In: Clinical Ophthalmology. 4th ed. Boston: Butterworth-Heinemann; 1999:69-71.

  18. Liesegang TJ. Atopic keratoconjunctivitis. In: Pepose JS, Holland GN, Wilhelmus KR, eds. Ocular Infection and Immunity. St. Louis: Mosby; 1996:376-390.

  19. Roy FH. Ocular Differential Diagnosis. 7th ed. Philadelphia: Williams & Wilkins; 2002.

  20. Shelley WB, Shelley EB. Atopic dermatitis. In: Advanced Dermatologic Diagnosis. Philadelphia: WB Saunders Co; 1992:285-291.

  21. Uchio E, Miyakawa K, Ikezawa Z, Ohno S. Systemic and local immunological features of atopic dermatitis patients with ocular complications. Br J Ophthalmol. Jan 1998;82(1):82-7. [Medline].

  22. Weisbecker CA, Fraunfelder FT, Rhee D. Physicians' Desk Reference for Ophthalmology. 28th ed. Oradell, NJ: Medical Economics Co; 2000.

  23. Zimmerman TJ, Kulkarni PS, Meredith TA. Steroids in ocular therapy, antibiotics and antifungals, antiallergic therapies. In: Zimmerman TJ, Kooner KS, Shariv M, Fechtner RD, eds. Textbook of Ocular Pharmacology. Philadelphia: Lippincott-Raven; 1997:61-74, 363-385, 609-633,683-701, 801-804.

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