DERMATOLOGY
Etiology
Genetic filaggrin mutation → impaired skin barrier
Atopic history (asthma, allergic rhinitis)
Environmental triggers (soaps, cold weather)
Pathogenesis
Barrier dysfunction → increased water loss → allergen penetration
Th2-mediated immune response → chronic inflammation
Clinical Features
Pruritus (hallmark)
Eczematous patches on flexor surfaces
Infants: face and extensor surfaces
Lichenification from chronic scratching
Secondary infections (S. aureus)
Treatment
Emollients
Topical steroids
Calcineurin inhibitors (tacrolimus)
Antihistamines for itch
Dupilumab (severe cases)