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Atopic Dermatitis High-Yield Review: Etymology, Diagnosis, Pathogenesis, Cytokines, Microbiome, Distribution, and Mimickers | The Derm Resident
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Hosts Dr. Jonny Hatch and Dr. Deven Curtis review high-yield atopic dermatitis (AD), covering its 1923 “atopos” etymology, clinical definition, and the atopic march (AD/food allergy in infancy, asthma in childhood, allergic rhinoconjunctivitis in adolescence). They outline AAD diagnostic criteria: pruritus, classic age-specific morphology/distribution, and chronicity, plus intrinsic (IgE-associated) vs non–IgE AD. Pathogenesis is framed as barrier dysfunction, immune dysregulation, and microbiome alteration, highlighting filaggrin’s role, transepidermal water loss, increased skin pH, and unchecked kallikrein proteases; Netherton syndrome (SPINK5/LEKTI) is discussed. They review Th2→Th1 evolution, key cytokines (IL-4/13 targeted by dupilumab; IL-13-only agents; IL-31 “itch cytokine” and nemolizumab), Staph aureus colonization and impetiginization, age-based distribution patterns, site variants and stigmata (Denny-Morgan lines, white dermatographism, keratosis pilaris, ichthyosis vulgaris), complications (ocular disease, eczema herpeticum with IV acyclovir on boards), quality-of-life impact, biopsy rationale (spongiotic dermatitis, rule out mycosis fungoides), and common mimickers and differentials including seb derm, scabies, contact dermatitis, immunodeficiencies, hypereosinophilia causes, nummular dermatitis, SCC in situ, dyshidrotic eczema, and asteatotic eczema.
00:00 Welcome and Topic Setup
00:31 Atopic Derm Name Origin
01:59 What It Is and Atopic March
04:41 Diagnosis Criteria Essentials
06:13 IgE Types and Core Pathogenesis
08:32 Barrier Breakdown and Filaggrin
13:02 Proteases and Netherton Syndrome
15:11 TH2 to TH1 Cytokine Shift
18:09 Dupilumab IL4 IL13 Explained
21:24 IL31 The Itch Cytokine
23:57 Staph Aureus and Microbiome
27:10 Age Based Distribution Infants
27:53 Age Based Distribution
29:32 Site Specific Variants
31:18 Head Neck Dupixent
31:58 Atopic Stigmata Signs
34:24 Ichthyosis And KP
36:09 Ocular Complications
37:55 Eczema Herpeticum Urgency
40:07 Quality Of Life Burden
42:27 When To Biopsy
45:18 Mimickers And Immunodeficiency
49:31 Eosinophilia Differential
50:22 Rapid Fire Dermatitis
53:25 Episode Wrap Up
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