The following symptoms and complaints may indicate atopic eczema (neurodermatitis):
In infants and young children
Leading symptoms
- Weeping, inflammatory patches (exudative eczema of the face).
- Whitish-grayish crusting (= cradle cap; weeping scalp eczema of the infant).
- Itching
- Scaling
The predilection sites (body regions where the disease occurs preferentially) in infants are the face in the cheeks, neck, groin and extensor sides of the extremities. In generalized infestation, usually exclusion of the diaper region (= diaper sign; helps differentiate from infant seborrheic eczema).
In adolescents and adults
Leading symptoms
- Itchy eczema – erythema (redness of the skin) – on the flexor sides of the extremities, especially the elbow.
- Localized eczema such as hand eczema or lichen simplex chronicus (localized, chronic inflammatory, plaque-like and lichinoid (nodular) skin disease that progresses in episodes and is accompanied by severe pruritus (itching)) [adolescents and adults].
- Prurigoform (prurigo = Latin itching) – with severely itchy nodules and lumps especially on the shoulder girdle and upper extremities [adults].
- Scaling
- Oozing
- Crusting
The predilection sites in adults are usually the flexures of the joints and face, neck, neck, shoulders and chest affected.
Note: Manifestation at the genital mucosa is possible.
Associated symptoms
- Perioral pallor – pale skin around the mouth.
- Dennie-Morgan wrinkle – extra fold of skin below the lower eyelid.
- Frequent skin infections
- White dermographism – after mechanical irritation of the skin, it turns white for a long time
- Dull, dry skin
- Lichenification – coarsened surface relief in chronically affected skin regions.
- Ichthyosis vulgaris – cornification disorder of the skin (occurs in circa 50% of patients).
- Nail symptoms (frequency 25%): shiny nails, cross grooves, spotted nails, paronychia (nail bed inflammation).
- Keratoconus (progressive thinning and conical deformation of the cornea of the eye) – as corneal manifestation.
Minimal variants of atopic dermatitis (all ages)
These include:
- Cheilitis (inflammation of the lips)
- Perlèche (perlèche (dialect form of pourlèche), to French pourlècher = lick all around; see also angulus infectiosus (oris), lazy corner, sparrow corner).
- Earlobe rhagades