Eczema (atopic dermatitis) – causes, symptoms, diagnosis, treatment, pathology

Eczema (atopic dermatitis) – causes, symptoms, diagnosis, treatment, pathology

Atopic dermatitis or atopic eczema is a skin
rash that’s particularly common among young children, but can last into adulthood. “Atopic” refers to an allergy, “derm”
refers to the skin, and “itis” refers to inflammation. So atopic dermatitis describes skin inflammation
that results from an allergy, more specifically, it happens when the immune system attacks
the skin causing a dry, itchy rash on flexor surfaces of the body, areas like the creases
of the wrists, the insides of the elbows, and the backs of the knees, as well as exposed
skin surfaces like on the face, the hands, and the feet. When the immune system inappropriately starts
attacking itself, we call that a hypersensitivity reaction, and there are four types. Atopic dermatitis is a type 1 hypersensitivity
reaction, and it starts off with something in the environment called an allergen, like
flower pollen. The pollen is able to travel through the slightly
porous skin, where it gets picked up by an immune cell in the tissue just below. The immune cell is called an antigen presenting
cell because it presents a bit of the allergen to a naive T helper cell, activating it into
a Th2 cell. This Th2 cell then stimulates a nearby B cell
to start producing IgE or immunoglobulin E antibodies specific to that pollen. Those IgE antibodies bind to the surface of
other immune cells called mast cells, as well as basophils, which can be found in the tissue
layer just below the surface of the skin, and this process called “sensitization”. Now, let’s say that there’s a second exposure
to pollen that makes it’s way into the skin tissue. Now, the allergen can cross-link the IgE on
these sensitized cells, resulting in degranulation or release of a number of proinflammatory
molecules like histamine, leukotrienes, and proteases. The combined effect of these molecules is
to cause nearby blood vessels to dilate and become leaky as well as attract even more
immune cells to the area creating inflammation of the skin tissue. Ultimately, the inflammation makes the skin
barrier more “leaky”, potentially allowing in more of the allergen, while at the same
time allowing water to escape, leaving the skin dry and scaly. Dry skin is very itchy, and scratching further
damages the skin barrier, worsening the process and setting up a vicious cycle of allergy-mediated
inflammation, dry skin, and itching which characterizes atopic dermatitis. Occasionally, bacteria can invade the damaged
skin causing even more inflammation. In infants, the rash is most often on the
face and scalp, and in children, the rash is usually on flexor surfaces of extremities. Atopic dermatitis can worsen in the presence
of allergens like cigarette smoke, mold, and dust mites, as well as changes in the weather,
and even emotional stress. Although it usually causes patches of red
itchy skin that come and go, the skin can occasionally even blister and peel. Over time, the skin can become lichenified,
which literally means turned to leather. Itchiness is often worst at night, perhaps
because there are no distractions, and this is often when young children are most likely
to scratch at their eczema lesions. Because eczema is an autoimmune mediated process,
it cannot be spread to other people, but since it affects the skin and therefore the way
a person looks, there is still a lot of social stigma associated with it. Unfortunately, many individuals especially
teenagers and young adults with atopic dermatitis suffer from depression and social anxiety
as a result. Genetics plays an important role in atopic
dermatitis, and individuals with atopic dermatitis often also have asthma, as well as allergic
rhinitis, making up what’s called the atopic triad. These illnesses also often run in families. Occasionally, atopic dermatitis can be part
of a syndrome like Hyper IgE syndrome, which has an autosomal dominant form commonly called
Job syndrome, phenylketonuria, which is a metabolic disorder that results from a buildup
of the amino acid phenylalanine, and Wiskott-Aldrich syndrome, which is an X-linked recessive disease
characterized by a clinical triad of eczema, thrombocytopenia, and immunodeficiency. Atopic dermatitis is generally a clinical
diagnosis, and there are ways to help break the cycle of allergy-mediated inflammation,
dry skin, and itching. With regard to allergy-mediated inflammation
it’s important to identify and avoid any triggers, as well as avoiding overheating,
dressing in soft fabrics, and managing stress well, which is of course a good life habit
anyway. Dry skin can be managed with frequent moisturization,
which is usually best to apply after a lukewarm bath. And itching can sometimes be managed with
simple measures like keeping fingernails short, and trying to keep children from scratching. But in more extreme cases, there are also
steroids and calcineurin inhibitors both of which aim to dampen the immune reaction, as
well as antihistamines that can help with itching, and antibiotics to help treat infections
if their needed. Alright, as a quick recap, atopic dermatitis
also called atopic eczema, is a type 1 hypersensitivity reaction in the skin, and is characterized
by a cycle of allergy-mediated inflammation, dry skin, and itching that most commonly affects
infants and young children. Atopic dermatitis can be managed by minimizing
exposure to allergens, keeping the skin hydrated, and minimizing itching. Thanks for watching, you can help support
us by donating on patreon, or subscribing to our channel, or telling your friends about
us on social media.


  • california8901 says:

    How long does it take to go away??

  • Irtaza Rehman Lectures says:

    Nicely explained

  • Valérie Barbin says:

    Could the itching worsen in the evening, because our cortisol levels go down at night?

  • tinnu1965 says:

    beautifulpower point presentation. which programme /software did u use for presantion. i want to present a similar presentation in my hospital, but not the usual pp presentaion

  • علا/ ستارز hamad says:


  • Kay X says:

    I just started having this. My Dr. prescribed a low dosage of steroids and my skin was beautiful again, until I slowly weaned off. Stress def triggers it

  • A K says:

    I've had it all my life ever since I was 2. Now I'm 16 and it's only worse, both arms, now on my legs, used to have it on my face but it is gone thank God. Spent a lot of money on ointments, vitamins, oils, changed my diet but nothing, absolutely nothing. It's hard to sleep, to bend my arms. It's torture. But I still hope for the best, lets hope the next doctor will have better results.

  • Gnarly Mothballs says:

    4:15 legit cryin cuz I have those three illnesses and it never went away….

  • Gnarly Mothballs says:

    Actually my school uniform makes my skin go back to the cycle cuz its very rough and we HAVE TO PUT ON A TIE EVEN IN SUMMER but im forced to wear it……. guess eczema will be as FUN as my period ahahah…..

  • LunaDaMisfit says:

    Me: da hell do you say that xD

  • shwetha shankar says:

    Hi sir. Is it completely curable?

  • AHealthyBeat says:

    nice Video.. Please make a video on Psoriasis please

  • KleineNisi says:

    so but what if you get atopic dermatitis at the age of 17 years, and the doctors assume, just like in the video, it is an allergic reaction. so I let my self test on what kind of allergen I am allergic to, and my blood test says there are absooolutley ZERO IgE in my blood, so it can not be an allergic reaction, and I still have a fucking annoying itchy eczema on both (inner sides) of my hands.
    what could possibly be the trigger to my dermatitis if not an allergic reaction and none of the in video mentioned syndroms (no hyper IgE (because zeerrooo IgE in my blood), no phenylkentonuria and no wiskott aldrich (because no thrombocytopenia and no immunodeficienty) ??

    I would love to get an answer from you guys 🙂
    thanks for all your videos, they really help me study for my pathology exam 😀

  • Charlotte Bouilloux says:

    My life resumed in 6 mins

  • Sunny :D says:

    I have eczema

  • Adrian Petkov says:

    Do EoE video

  • noctusowl says:

    New research show IBS can also be part of the atopic syndrome. Also the immunosuppression caused by the disease is more common than previously thought. With just one element an individual has double the risk of upper airway infections like colds and flu, and triple the risk of pneumonia.

  • Dr Bhavana P says:

    Very nicely explained… Made easy to understand.

  • Bhanu Prakash Buddha says:

    Isn't it type IV hypersensitivity for eczema

    Please clear, tomorrow i got exam

  • Natural Health says:

    Someone know what triggers your eczema?

    1:- Allergies
    2:- Soaps, detergents, etc.
    3:- Stress

  • Evey cho says:

    Thank u so much for this vdeo
    Can I ask if there is any reference?

  • Cynthia Alves says:

    I Love the channel, you're amazing! Please do more videos of dermatologyc's diseases ❤️

  • no says:

    I had this when i was 6, now im 13 and it came back ):p

  • OrangeDude says:

    I have eczema and everything you have said has happened to me

  • Alek _AN says:

    My life…

  • Samara Gharial says:

    Does anyone else take methotrexate?

  • Aelia Laelia says:

    It really sucks

  • Nolvora says:

    I have the atopic triad…yikes!

  • Star Mayhem says:

    This negative feedback loop is pretty lame right? I can't concentrate at all.
    I'm testing to see if i stop showering will make me less allergic to the environment, i'll update in a month or two.

    edit: Not to be confuse, I only stop showering, but maintain other personal hygiene, brushing teeth, wash my face, regularly change clothing/blankets etc.

  • Ramesh Chavda says:

    Make video on vitiligo

  • sowxn gfrd says:

    i have this disease too

  • sowxn gfrd says:

    mine is bleeding

  • Dizza Mae Ipio says:

    this is my life for 21 years and counting. ghad

  • Prankitup says:

    I'm a student that's looking to be a pre-med. There is so much information in this video… How do you know what's important to study?

  • chidimma ezugwu says:


  • Translation Guy says:

    Great as usual 👌

  • HaloWolf58 says:

    I have atopic and it basically appears during winter in an annoying dry crusty form which I have to control with some skin hydration cream. However it does calm down and sometimes even dissapears during summer completely only to return in autumn. It’s an itchy annoyance that sometimes feels like someone has set fire to your hand when it becomes inflamed. I’m 13 now and the dermatitis is only on my hands.

  • RadecRanger says:

    I have this shit, I hate it. My Legs are the ones exposed and ITS SO GODDAMN ANNOYING. I feel so unlucky on how im literally the only guy in class that have this shit. After showering it triggers this. This makes my stressed out life even worse, after visiting a dermatologist, I was sent to a machine, which exposes controlled light on my skin, known as Phototherapy. Which has helped a lot, but my parents decided to stop using it since “it got better” ( no it literally came back, with some improvements ) and I WISH that a cure would magically appear.

  • Callum spencer says:

    I also have alergys

  • Dr.Mahajan Nilesh says:


  • Coral Crunch says:

    Hey Osmosis, when I was 11 or 10 (not really sure) I started having small bumps between my fingers, on the back part of my foot & near my elbows. I saw the bid but you said it will also cause dry skin. Apparently, I'm a very sweaty 13 year old teen and I never had dry skin (my phone is wet from sweat right now). Can you please help me
    Accidental Genius

  • madhurjya roy says:

    Great sir

  • Kalani W says:

    I have had eczema for years, it’s on one of my fingers completely at the moment and I have a bit on my thumb. It doesn’t usually get itchy but I still scratch it when it looks very dead. And I think it gets worse when I have some types of chocolate and ice cream which is a pain.

  • Miami Doorstep says:

    Ever since I was in 6th grade I had it. It was so bad to the point if one drop of hydrogen peroxide had contact with my face it would fizz and white foam would spill out. My parents did not take me to a doctor until 3 years later. How I survived was putting Aloe and sunflower seed oil to my face 2 times a day. For those who are suffering from it, I would suggest this method. It is not a guarantee it will work but it doesn't hurt trying. I won't get the cream mediation in 72 hours so hopefully, it will cure me. Thank you for uploading this video it reaaly gave me insight on what my condition was.

  • atharva ambure says:

    I am suffering from it…. 😥 yah…I am just 15 and the shit is with me from 12 yrsss it's really bad…

  • CSJibbx says:

    had this disease my whole life, my brother grew from it when he was 12, im 17 now, and still have it. It worsened when i hit puberty. I've learned to kind of control it now, so its not that bad. But when it worsened, I struggled a lot with social anxiety and depression. When can I expect to grow from it, or will i always have it?

  • Erwan Umbukan says:

    I have been dealing this eczema, for 7 yrs before it was treated by my doctor.. but I failed to maintain now. .. the leathering really shaming me… whoah so depressing

  • Super CAR says:

    all these skin diseases from parasites and fungi. 1/ remove the aggravation of the Allergy antihistamine antipruritic drugs. 2 / then start cleansing the body of parasites, worms, protozoa and fungi!! 3/eat live raw healthy food. 45% plants, (greens, vegetables, fruits) non-GMO 30% traditional dishes, i.e. boiled stewed food, and 15% pure meat without GMO or dairy products! 4 / more drink water 2-3 liters a day only water and additionally drink tea natural tea herbs fruit berries and their leaves. 5 / drink dietary supplements or decoctions from parasites every 12 days !!!

  • Rohit Tarsariya says:

    Nice vedio, hi sir pz vedio make on scabies plz.and Steven Johnson syndrome.

  • Gunjan Soin says:

    Good knowledge. My friend is using ATOPIC DERMATITIS CARE PACK by Planet Ayurveda and she is feeling much better.

  • Ask to buy me some Honey BBQ CHIPS says:

    Would Eczema be the cause of my eyebrows not having hair and bald?

  • Ida Hasselgren says:

    I have had it my entire life, it’s always at least one ecxema on my body but this spring it got really bad, but it wasent the 30 big eczema that was the worst part… it was the placement, I had one on my neck that looked like a hickey and one on my arm that was the shape of an d*ck and when they heald they had no pigmentation for like four months

  • I'm curious says:

    what are the different treatments used to cure the Atopic Dermatitis, and what would be the most effective one

  • Kurt Rozentaun says:

    I had it since i was born. All my legs are lichenified. But i think, it is my superpower 😀

  • Marco Wilhelmsen says:

    Yo is posible to scratch your pigment off If You scratch to much? Because i have lost half of my color on my inner elbows. And Could sun tanning or anything Else work to Get my color back?

  • danielle potts says:

    I’ve had it all my life so 16 years and what I hate the most is people say I’m making it sound worse than it is once I stayed off school to go to the doctors and my friends just said it’s only a itch well yeah it’s a itch but it’s painful and I can’t wear what everyone else wears I live in hoodies to nice my arms and chest it’s annoying, and on top of that my doctors gave me these oils and I put them on and was rushed into hospital because apparently those oils aren’t meant to be in contact with cracked skin so they had me in hospital for 2 days xx I have found that getting bandages that are tight and lathering your arm in cream or moisturiser and putting them on helps I do it to sleep in and go to school so as soon as I get home I take them off and let my arms breathe xx I have also found eating flax seeds helps so yeah hope it helps some of yous xxx

  • tikaram acharya says:


  • Khazem Eldabagh says:

    very well explained, however, I think part of the pathophysiology part is incorrect. The hypersensitivity reaction type one is mediated by the hemoral adaptive immunity. therefore, it is initially mediated by B cells, plasma cells, and antibodies. I think the antigen must bind to the antibody within the dermis which than binds to the mast cells and presented to the T2 helper cells. which created a sensitization. could be wrong, but this is what I understood from my pathophysiology course.

  • Cnpu Ce says:

    Isn't Atopic dermatitis type 4 hypersensitivity?

  • Ahmed Saleh says:

    Eczema is type IV hypersensitivity not type I.

  • Ahmed Saleh says:

    Eczema is type IV hypersensitivity not type I.

  • bani anand says:

    My life in 6:30 minutes

  • Naeem Tasir says:

    Sir you are great

  • Rasina Afreen says:

    i had a very bad eczema few years back , i even had bleeding because of the scratch , i was prescribed eczema medication (bethamathasone cream) by the dermatologist , i applied a very thin layer of the medication , leave it dry to absorb for 15-20 mins and follow up by applying moisturizer over . I did this for few day every night and i am still following up . Now i have no trace of eczema , people only know when i say . As per video cutting finger nails, moisturizing and keeping away from the allergens like dust really works .

  • Kristina Čolak says:

    None of the creams that were suggested to me helped. Only thing that actually helped me a lot was all natural carrot oil. It's actually made for tanning in the sun but I don't see a huge difference regarding that. I would rub it from head to toe after every shower. I started seeing difference after maybe a month so be consistant. I hope this helps you as much as it helped me. Good luck 😊

  • kalva anithakumari says:

    Eczema refers to inflamed skin it is not a contagious disease its exact cause is unknown the causative factors are bacteria, pollen, irritants, and allergens. Homeopathy Treatment can help to cure the Eczema problem consult now.

  • Giada Galvano says:

    I love you guys!!

  • M jr says:

    Subtítulos en español

  • Tony Mak says:

    This video sounds to have accumulated information from all the medical professionals I have ever visited. Very technical. None have ever suggested that it starts from the stomach. None have ever solved my problem skin Although I confess that my eczema is not as severe as some have described, on occasion it does appear quite severe, and when one recovering patch might give you hope that you are doing something right, the suppression in one area seems to make a different patch spring up somewhere else. I have had eczema since childhood, and numerous treatments. Once as a child even a weeks hospital stay. You will all recognise the patches behind knees and crooks of elbows, mine seemed never ending.
    I decided at one time that whenever I needed to scratch, I would do it with my left heel on my opposite right ankle, no matter where my itch was, in order to save the areas that were sore. Bizarre thought really, but guess what ?, I ended up with the worst patch I'd ever had on. My right ankle, always sore and bleeding, but at least it didn't show. I would be I my mid 30s, and under the care of a large UK city teaching hospital specialist, he recommended a treatment of exposure to X Rays, in order to thicken up the skin affected by the steroid creams, which cause the skin to thin out. The treatment was a bit of a toil, various parts of clothing coming on and off, lead shielding , so when the operator asked if there were any more areas after she had done my body and legs, I omitted to tell her about my ankle, I've no idea why, I was just fed up. Anyway some time much later, maybe even a year or more, I realised my eczema had cleared up, the skin on the insides of my elbows, hands, behind my knees, AND ankle was as smooth as silk. Not even an itch.

    When I thought back of anything significant, I recalled I had had a severe case of food poisoning, that had laid me low for a couple of days.I'm not suggesting anyone go out and try it, but to this day, the folds of elbows and knees, ankle, have been no trouble whatsoever, I don't even think I have ever scratched them once. I did return to see the specialist since my eczema returned and appeared in my face, however when I told him about the food poisoning, he dismissed it without a thought, and recommended more of the same steroid creams. He might have well just said "quack quack". I feel sorry for any of his patients if he is still practicing.
    So apologies to any medical professionals preaching the message given here, but I have little faith in the idea that the skin is the problem. I can catagorically say for instance that the areas of my hands, once rough and sore even bleeding, fingers which cracked in winter and never healed, are now as soft as you could wish. The healing needs to come from within, it's what you are eating. Best of luck.

  • Rockin Rollin n Trollin says:

    can you do this all again in english ?

  • princess R says:

    Watching while itching… 🙁

  • Harshil Parmar says:

    Isn’t eczema type 4 hypersensitivity reaction?

  • Space Blend says:

    if felt like i was the only person on earth with eczema until i read how much people in the comments have it

  • Jason Kawalsky says:

    This is wrong. Eczema is a type IV hypersensitivity reaction and involves T cells

  • iZylos says:


  • Stein’s Voice says:

    Those who has eczema or dermatitis whatever it is, should stop eating sugar and stop smoking cigs.
    And drink water as much as you can. Thank me later

  • Nomadic Mind LTU says:

    video is boring, not helpful, and your voice is annoyable..

  • James Smallwood says:

    I use cannabis infused cocanut oil we make out of all the plant it help really good

  • Rajesh Dev says:

    Very nice explanation. Thanks osmosis

  • Karen Benton says:

    Flax seed oil seem to help me. I rub it on my hands which is where my dermatitus is mostly it stops the itching

  • Modern IsAwesome says:

    I Have Atopic Dermatitis,And I Hate It

  • Modern IsAwesome says:

    I Got The Atopic Dermatitis From My Dads DNA,Why Cant I Just Get My Moms DNA

  • Anna Elisa Laserra says:

    I think this video lacks of important information. First I don't think it's appropriate to call it an "auto immune mediated process", but basically you only described the type 1 Ig mediated mechanism, while in AD there is a mixed pathogenesis, of both type 1 and type 4 hypersensitivity. Despite I love your channel, this video was a little disappointing.

  • TheWorstGachaTuber says:

    Yeah I have eczema but I got prescribed a cream that made most of it go away. Now it only comes back when I'm stressed, near cats (cause I'm allergic) , or I constantly touch some part of my hands on something else. I play violin, and holding the bow can sometimes cause eczema to appear on some parts of my hands.

  • TheWorstGachaTuber says:

    The strange thing is tho, I don't rly scratch my eczema unless it's itching REAL bad, which is only sometimes. I think that's why it's not so bad for me . I control myself.

  • TheWorstGachaTuber says:

    Yeah actually my skin ALWAYS gets blisters and peels when i have a flare up

  • TheWorstGachaTuber says:

    I HATE taking antibiotics , but once my eczema kept getting so worse it was affecting how I did in school, and I am usually a straight A student , so I took antibiotics cause my mom told me to and ultimately that's what made the horror stop. Now I don't rly get it as much

  • Raging Fury says:

    everything u just said applies to me, thanks for this summarized straight to the point explanation.

  • Nelum Chamila says:

    how does eczema happen

  • Rawrdy A says:

    i have eszema and i wear anything that will cover the back of my knees because it embarrassed me everytime i go to the public,… even my uniform skirt needs to be long so i will have a little confidence even though im insecure of it … one time tho we had an event in my school and i need to wear mini skirts and it gives me anxiety just thinking of it and it even got to the point that i dont want to go to school because of it. my friend saw the back of my knees and told me "eww why is it dark" and it makes me sad that i cant wear anything i like because of it…(i have eszema and asthma and hope no rhinitis because my life is already sad)

  • little miss XXX says:

    I have atopic dermatitis, asthma and allergic rhinitis. 😭💔 My grandmother and my uncle have the same problem. My mother only has asthma and allergic rhinitis, but never had eczema. My skin is always itchy! It has been disturbing my sleeping pattern. I can't sleep now that's why I ended up watching this very informative video. I hope my eczema would be gone forever. 😥

  • Lulu a says:

    I had aczema Sense i was born .. i’m 13 now ..
    It’s really annoying 🥺

  • Gaming With Noah says:

    Sorry, but I'd rather have eczema than skin cancer, smh.

  • Madison Mitchell says:

    Ppl at school laugh and say eww wat is dat stuff on my legs and arms. I said eczema and they said ew dont com by mee freak i said its not a disease it jus eczema

  • Beyonce Obsessed fan says:

    I had it

  • raneesh vpz says:

    Add more vedios on dermatology….this chanel helped me alot in my learning. My teacher❤️💟

  • GoldenDelicious78 says:

    If it’s not itching but only feels like a burning sensation and the skin is not dry or flaky…could it still be ecsema??
    I’ve never had these problems my whole life. Now I’m 40 and have been suffering from this since May.
    It started around my eyes and a few weeks later I got it also in my arms. The eyes and arms was not only feeling burning sensation but also itching. So they gave me steroids. But its never 100% gone. like yesterday I woke up and I had two small red spots on my forehead itching and a spot on my neck . Further, my underarms and the back of my hands I felt burning sensation (not itching and not red.) Today when I woke up the red spots on my forehead and neck were gone but my underarms and back of my hands, I still feel the burning sensation (but its much better than yesterday.) Is this still considered ecsema or what is this? (I know stress and my sensitivity to sun has something to do with it.) I know the day I sleep well and don’t have to work or is trying to relax, the burning sensation goes away.
    But I’m wondering if I really should treat a this with steroids since it can feel different from day to day? Is this really ecsema or should I treat it like something else? Should I not treat it with steroids at all but only put moisturising cream on it and hope it will go away by it self.
    Would be thankful for any response on this.

  • amber BLLUE says:

    I have eczema since birth and it sucks..i have darks spots from past scars and im very insecure about my skin so I dont really wear clothes that shows too much skin even my legs..I wear pants all the time and I want to wear dresses but I cant

  • Bilal Ameer says:

    Any permanent treatmnt????

  • Aleksium-6 says:

    Im 35 five and every so many years Eczema strikes again and strikes hard. Usually it's the wrists and hands but sometimes it gets where I least expect it to and I'll think it's something else. One time I didn't wash and dry underneath my wedding ring and that's where it hit. I had a red ring of bursted and scratched skin that was the shape and placement of my wedding ring. At that same it got to my lower male anatomy!!!!! It was hell. Eczema is a fact of life at this point but damn that itching is pure misery. This video told more than I ever knew about eczema. Thank you and cheers to all my fellow eczema brothers and sisters.

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