| Signs are often, but not always, seasonal. Pruritus is the hallmark of atopic dermatitis and may be the only complaint. This gives rise to self-trauma, causing lesions. Lesions commonly include alopecia, erythema, scaling, crusting, excoriations and salivary staining. Macular-papular eruptions are occasionally seen<sup>2</sup>. With time, lichenification, and hyperpigmentation develops. Because the route of allergen contact is thought to be percutaneous absorption<sup>1, 2</sup>, it follows that hairless regions are most frequently affected: the face, ears, axillae, feet and inguinal regions are predilection sites. Secondary infections such as superficial staphylococcal pyoderma and [[Malassezia pachydermidis|''Malassezia'']] are common, and otitis externa often occurs concurrently<sup>2, 3, 4</sup>. A small number of cases exhibit only chronic or recurrent otitis externa. Another uncommon presentation is allergic rhinitis, manifesting as sneezing, nasal discharge or allergic conjunctivitis<sup>1, 2</sup>. | | Signs are often, but not always, seasonal. Pruritus is the hallmark of atopic dermatitis and may be the only complaint. This gives rise to self-trauma, causing lesions. Lesions commonly include alopecia, erythema, scaling, crusting, excoriations and salivary staining. Macular-papular eruptions are occasionally seen<sup>2</sup>. With time, lichenification, and hyperpigmentation develops. Because the route of allergen contact is thought to be percutaneous absorption<sup>1, 2</sup>, it follows that hairless regions are most frequently affected: the face, ears, axillae, feet and inguinal regions are predilection sites. Secondary infections such as superficial staphylococcal pyoderma and [[Malassezia pachydermidis|''Malassezia'']] are common, and otitis externa often occurs concurrently<sup>2, 3, 4</sup>. A small number of cases exhibit only chronic or recurrent otitis externa. Another uncommon presentation is allergic rhinitis, manifesting as sneezing, nasal discharge or allergic conjunctivitis<sup>1, 2</sup>. |
| Histological changes are non-specific but include acanthosis, a mixed mononuclear perivascular dermatitis, sebaceous gland metaplasia and secondary superficial pyoderma<sup>1</sup>. | | Histological changes are non-specific but include acanthosis, a mixed mononuclear perivascular dermatitis, sebaceous gland metaplasia and secondary superficial pyoderma<sup>1</sup>. |