BACKGROUND: Atopic 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 lesional difference in the severity and reactivity to treatment. OBJECTIVE: The aim of this study is to primarily determine the difference in lesional predilection and lesional severity of atopic dermatitis. Second objective is to compare lesional 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.
Animals ; Ankle ; Child ; Dermatitis ; Dermatitis, Atopic ; Human Body ; Humans ; Hydrogen-Ion Concentration ; Hygroscopic Agents ; Skin ; Tacrolimus ; Wrist

BACKGROUND: Atopic 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 lesional difference in the severity and reactivity to treatment. OBJECTIVE: The aim of this study is to primarily determine the difference in lesional predilection and lesional severity of atopic dermatitis. Second objective is to compare lesional 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.
Animals ; Ankle ; Child ; Dermatitis ; Dermatitis, Atopic ; Human Body ; Humans ; Hydrogen-Ion Concentration ; Hygroscopic Agents ; Skin ; Tacrolimus ; Wrist

Though there is ambiguity in its medical definition, dry skin is a frequent skin problem of increasing importance these days. Generally "dry skin" denotes the status of skin showing erythema, roughness, scales, and itching resulted from low water content in the skin. Abnormalities in epidermal lipids, natural moisturizing factors, or corneocyte desquamation are regarded as important factors in its pathophysiology. It is not only accompanied with skin aging, but with various kinds of skin and systemic diseases(such as atopic dermatitis, ichthyosis, chronic renal failure, and diabetes mellitus). Important principles in the management or treatment of dry skin are preventing excessive washing and keeping moisture in the epidermis. For gentle cleansing, mild surfactants are better than the soap. Moisturizers are applied to the surface of skin to increase epidermal water content. Two different kinds of moisturizers are used as a mixture for the best result. Humectants are the material that draw water from the air or dermis. And emollients are the material that protects membrane by preventing water from evaporating from the epidermis. Though moisturizers are very helpful in management of dry skin, harmful result may happen by inadequate selection and wrong use.
Dermatitis, Atopic ; Dermis ; Emollients ; Epidermis ; Erythema ; Hygroscopic Agents ; Ichthyosis ; Kidney Failure, Chronic ; Membranes ; Pruritus ; Skin Aging ; Skin* ; Soaps ; Surface-Active Agents ; Water ; Weights and Measures