Table 2.

Common Conditions in the Differential Diagnosis of Atopic Dermatitis

ConditionMorphologyDistributionPertinent Signs/Symptoms
Atopic dermatitisAcute to chronic dermatitic lesionsInfant: face, head and neck, extensor surfaces
Child: flexural folds with the wrist, ankles, hands, feet, and antecubital/popliteal fossae
Adult: flexural surface; many area-specific subtypes
Pruritus; personal or family history of atopy
Irritant contact dermatitisAcute to chronic eczematous lesionConfined to area of exposureBurning/itch
Allergic contact dermatitisAcute to chronic eczematous lesionInitial confinement to area of exposure but likely to spread
Seborrheic dermatitisIll-defined areas of erythema with greasy scaleNose, nasolabial folds, eyebrows, glabella, scalp
Children: cradle-cap and diaper area often affected
Children: self-resolving within 2 weeks
PsoriasisBright beefy-red, well-circumscribed plaques with silvery micaceous scaleBroad distribution with extensor surface involvement
Children: diaper area often affected
Nail changes (including pitting; family history of psoriasis)
ScabiesContiguous burrows of serpiginous tracks with secondary eczematous changesChildren: palms, soles, dorsal feet, genitalia, diaper area
Adults: interdigital space, wrist, axillae, waist, umbilicus, nipples, genitals, breasts
Severe pruritus, worse at night; excoriated papules in multiple areas