Atopic dermatitis complications

De novo occurrence of the filaggrin mutation p.R501X with prevalent mutation c.3321delA in a Japanese family with ichthyosis vulgaris complicated by atopic dermatitis. J Invest Dermatol 128, 1323-1325. 

Smallpox vaccine is not recommended for use in certain groups who may be at risk for complications of the vaccine, in up to 0.2% or more of immunized populations, immunosuppressed individuals, pregnant women, and patients with atopic dermatitis may develop complications related to vaccinia, the orthopox virus used in smallpox vaccine. Vaccinia immunoglobulin can be given to those at risk for these complications. Smallpox vaccine can also be given up to 4 days postexposure as postexposure prophylaxis with significant reduction in mortality. 

Dermatologic disease and its related ocular complications are commonly encoimtered entities in general ophthalmic practice. The conjimctiva frequently is affected with ocular involvement. Although numerous dermatologic conditions can affect the eye, this section focuses on the three conditions that are most often encountered acne rosacea, psoriasis, and atopic dermatitis. 

Therapy for the eye-related complications of atopic dermatitis focuses on reducing inflammation. Specific management of this ocular disease is discussed in Chapter 27. 

Surgical intervention in atopic dermatitis has been associated with a relatively high rate of complication. In particular, the incidence of retinal detachment is relatively high. The etiology is not clear, but one study noted breaks in the pars plicata of the ciliary body in four eyes of three patients with atopic dermatitis. 

Staphylococcal septicemia complicated by endocarditis has been reported in a 50-year-old woman after 5 months of treatment with mycophenolate for atopic dermatitis (25). 

As the skin of most patients with atopic dermatitis can be colonized with Staphylococcus aureus, the authors suggested caution in using mycophenolate, which can also cause leukopenia. This patient had previously taken ciclosporin and azathioprine, which were ineffective, but without apparent infectious complications. A specific role of mycophenolate is therefore debatable and the occurrence of bacterial septicemia may have been purely coincidental. 

SatcheU AC, Barnetson RS. Staphylococcal septicaemia complicating treatment of atopic dermatitis with mycophenolate. Br J Dermatol 2000 143(l) 202-3. 

Eczema vaccinatum, a potentially serious complication, occurs in people who have eczema, atopic dermatitis, or a history of eczema or atopic dermatitis. It can also occur in vaccine recipient contacts with these conditions. Eczema vaccinatum is... 

One of the most feared complications of conventional treatment with topical steroids to treat atopic dermatitis has been the development of cutaneous atrophy. 

Because of the bronchial muscle relaxant effect, caffeine is used in chronic obstructive pulmonary disease and for the treatment of asthma. The use of caffeine in the treatment of children with minimal brain dysfunction, to increase the duration of electroconvulsive therapy-induced seizure, for allergic rhinitis, as well as for atopic dermatitis has also been described. Recently, caffeine has been used as a diagnostic test for malignant hyperthermia and in the diagnosis of neuroleptic malignant syndrome, a complication of neuroleptic therapy. 

Patients with AD can also present with eyelid dermatitis, nipple dermatitis, and cheilitis of the lips. Eyelid dermatitis and chronic blepharitis are commonly associated with AD, and can result in visual impairment from corneal scarring. Other ocular complications include atopic keratoconjunctivitis, vernal conjunctivitis, and keratoconus. ... 

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