Evaluation of clinical manifestation according to 'dermatitis mapping' in atopic dermatitis

Abstract

Background: Atopie dermatitis has a characteristic clinical manifestation and flexural distribution of lichenified eczematous plaques. Clinical manifestations and treatment of atopic dermatitis have been studied vigorously. However, Korean studies on clinical manifestation have mainly focused on predilection sites, and no study was performed about lesionai difference in the severity and reactivity to treatment. Objective: The aim of this study is to primarily determine the difference in lesionai predilection and lesionai severity of atopic dermatitis. Second objective is to compare lesionai reactivity to treatment with topical tacrolimus 0.1% ointment. Methods: Authors mapped the patients' dermatitis lesions by dividing human body parts at the first visit. Then, topical tacrolimus 0.1% ointment was applied to one side of the body and humectants were applied to the other side of body. In order to evaluate the reactivity to the treatment, transepidermal water loss, pH, and skin surface hydration were measured. Results: The frequency of involvement of wrist and ankle, as well as well-known predilection site, was high in children. More than half of the wrist and ankle lesions were grouped as severe. Although tacrolimus was superior to simple emolients in most lesions, reactivity to the treatment was low in wrist and ankle. Conclusion: The wrist and ankle, as well as other predilection sites were frequently involved with significant severity, and showed low reactivity to the treatment. These areas need to be carefully evaluated and treated. Dermatitis mapping might be helpful in clinical evaluation and management by visualization of lesions and changes.