Childhood atopic dermatitis .

In infancy it usually begins as itchy erythema of the cheeks . In the erythematous patches minute epidermal vesicles develop, rupture and produce moist crusted areas. The eruption may rapidly extend to other parts chiefly the scalp(Cradle) , neck ,forehead, wrists and often extremities . The eruption may become generalised involving buttocks and diaper area with erythroderma and considerable desquamation . Moist type _ Is most common. The lesions show polymorphism . Exudation may be marked and there are many secondary effects from scratching , rubbing and infection : Crusts ,pustules and infiltrated areas . The infiltrated patches eventually take on a characteristic lichenified appearance. Itching is severe and main symptom.

There is excessive dryness and Xerosis, which with pruritis predisposes to eczematisation . This is seen especially in older children in whom antecubital and popliteal fossae are invloved .
In most infants who suffer from this disease , the skin symptoms disappear towards the end of the 2nd year . The patients are able to eat without bad effects of foods which previously caused disturbance. Exacerbations are observed after immunizations (Mez, Thuja),colds(Alum, Petr, Psor). Partial or complete remissions of the dermatitis in summers and relapse in winters are usually seen, aggravated wool irritation and low humidity. The role of food allergy in infantile and childhood atopic dermatitis is still a debated point. Foods most commonly testing positive were Egg, Peanut, Milk, Fish, Wheat and Chicken.
Through out childhood less acute lesions in the same areas may recur. Such lesions as occur are apt to be less exudative, drier and more papular. The classic locations are the antecubital and popleteal spaces (Selen, Sep),the wrists ,eyelids, face (Carb.ac, Crot.t, Psor, Sulph)and about the neck. Pruritis is a constant feature. Itching is of compelling paroxysmal type with inability to feel the pain during the paroxysms (disseminated neurodermatitis). During childhood there is decrease in frequency of sensitization to non ingested substances particularly wool, cat hair, and pollens. Feather sensitivity also has its onset in childhood.