although symptoms may vary from person to person the most common symptoms are dry itchy red skin. itch is the grand hallmark of the disease. typical affected skin areas include the folds of the arms the back of the knees wrists face and hands. less commonly there may be cracks behind the ears and various other rashes on any part of the body. the itchy feeling is an important factor in atopic dermatitis because scratching and rubbing in response to itching worsen the skin inflammation that is characteristic of this disease. people with atopic dermatitis seem to be more sensitive to itching and feel the need to scratch longer in response. they develop what is referred to as the itch-scratch cycle. the extreme itchiness of the skin causes the person to scratch which in turn worsens the itch and so on. itching is particularly a problem during sleep when conscious control of scratching decreases and the absence of other outside stimuli makes the itchiness more noticeable. many patients also notice worsening of their itch in the early evening when they get home from work or school when there are less external stimuli to keep them occupied. when things at home sort of quiet down the itching seems to become more noticeable. how atopic dermatitis affects the skin can be changed by patterns of scratching and resulting skin infections. some people with the disease develop red scaling skin where the immune system in the skin becomes very activated. others develop thick and leathery skin as a result of constant scratching and rubbing. this condition is called lichenification. still others develop papules or small raised bumps on their skin. when the papules are scratched they may open (excoriations) and become crusty and infected. the box below lists common skin features of the disease. these conditions can also be found in people without atopic dermatitis or with other types of skin disorders.
what are the symptoms of atopic dermatitis?