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[Late-onset atopic dermatitis with nummular pattern].

Evelia Pautt-Lara1, Laura Cala-Castro, Olga Harris

  • 1Instituto de Ciências da Saúde Izamar Milidiú da Silva, Servicio de Dermatologia, Río de Janeiro, Brasil. eeveliapautt@hotmail.com.

Revista Alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
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Late-onset atopic dermatitis in adults can present atypically. Diagnosis requires a history of atopy, allergen sensitivity, eosinophilia, and skin biopsy for effective management.

Keywords:
AdultsAtopic dermatitisClinical heterogeneityFlexural dermatitis

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Area of Science:

  • Dermatology
  • Clinical Immunology

Background:

  • Adult atopic dermatitis (eczema) can manifest in adulthood, differing from childhood forms.
  • Late-onset atopic dermatitis often presents with varied clinical features, not always the typical flexural pattern.

Observation:

  • A case study of a 26-year-old man with allergic rhinitis and late-onset eczema featuring an atypical nummular pattern.
  • Skin biopsy revealed eczema-like lesions, supporting the diagnosis of adult-onset atopic dermatitis.

Findings:

  • The patient showed resistance to methotrexate, necessitating phototherapy due to systemic corticosteroid dependency.
  • Diagnosis was confirmed by integrating clinical presentation, patient history, and laboratory findings, including eosinophilia.

Implications:

  • Atypical presentations of adult atopic dermatitis pose diagnostic challenges.
  • Key diagnostic factors include personal history of atopy, aeroallergen sensitivity, eosinophilia, and histopathological examination of skin biopsies.