atopic dermatitis mimickers

When to Scratch Beyond the Surface of the Diagnosis—A look at Atopic Dermatitis Mimickers and Their Response to Topical Corticosteroids


Briar Findlay1Joseph M. Lam, MD, FRCPC,2

1 Paediatric Resident, BC Children's Hospital, Vancouver, BC.
2Associate Clinical Professor, Department of Paediatrics, Associate Member, Department of Dermatology, University of British Columbia.


Abstract: Many dermatoses occur in the pediatric population that can mimic atopic dermatitis based on their morphology or their propensity for triggering itch. This review will highlight some of the common skin conditions that can mimic atopic dermatitis, their typical response to topical corticosteroids and helpful features that can help distinguish these conditions from atopic dermatitis.
Key Words: atopic dermatitis mimickers, topical corticosteroids, chronic inflammatory skin disease, paediatrics.
Many dermatitic eruptions can mimic atopic dermatitis but features such as their typical response to topical corticosteroids can be a helpful distinguishing feature.
Some atopic dermatitis mimickers can worsen with topical corticosteroids and these include periorificial dermatitis and tinea corporis.
Some atopic dermatitis mimickers will only partially improve with topical corticosteroids alone and these include allergic contact dermatitis and molluscum dermatitis.
Other atopic dermatitis mimickers such as psoriasis and seborrheic dermatitis can respond to topical corticosteroids and the correct diagnosis can be made using other morphological or historical features.
AD is a prevalent, chronic and relapsing condition in infancy and childhood.
Morphology, distribution and age of onset can be important in distinguishing between AD and common mimickers.
Response to corticosteroids is not diagnostic for AD as many mimickers may have an initial or complete response to topical corticosteroids; however, corticosteroid usage in some mimickers of AD may lead to complications and unnecessary side effects of topical corticosteroids.
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