Atopic Dermatitis in Infants and Toddlers: a Diagnostic Challenge in Daily Practice

Abstract

The presentation of newborns (0 to 28 days), infants, and toddlers (28 days to 2 years) with eczematous skin lesions is always a diagnostic and therapeutic challenge. Although these lesions represent most commonly an early atopic dermatitis (AD), various other eczematous skin diseases must be ruled out. These differential diagnoses of early AD include immunodeficiency disorders. Ascertaining a diagnosis of early AD is difficult, because the clinical phenotype is extremely heterogeneous and pruritus, the hallmark of AD, is difficult to recognize at this early age. Most sets of diagnostic criteria for atopic dermatitis are not applicable in this very early age of life. Thus, the definitive diagnosis of early AD is challenging and may better be delayed with a preliminary diagnosis of indetermined "eczema infantum." Once the clinical characteristics become evident in the further course of the disease and the chronically recurring course can be assessed, a diagnosis of early AD may be made.

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