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Children
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Childhood Atopic Dermatitis: Diagnosis, Treatment and Management
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Childhood Atopic Dermatitis: Diagnosis, Treatment and Management

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Dermatology".

Deadline for manuscript submissions: closed (30 March 2026) | Viewed by 2168

Special Issue Editor

Prof. Dr. Regina Fölster-Holst

E-Mail Website
Guest Editor
Department of Dermatology, Universitatsklinikum Schleswig-Holstein Campus Kiel, Kiel, Germany
Interests: atopic dermatitis; pediatric dermatology; exanthems in childhood parasitoses
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atopic dermatitis (AD), also known as atopic eczema and endogenous eczema, is the most common inflammatory skin disease in childhood. This systemic disease is characterized by stigmatized lesions and intense itching, resulting in sleep loss and impaired quality of life. This Special Issue will focus on pathogenesis and clinical signs related to different age groups in childhood; in addition, it will provide updates on therapy and prevention measures. New insights have recently been acquired, particularly through barrier and immunological research, and have informed preventive measures. We welcome submissions covering the following topics:

  1. Epidemiology in childhood atopic dermatitis;
  2. Pathogenetic aspects;
  3. Age-dependent clinical signs and differential diagnoses;
  4. Therapeutic options;
  5. Preventive measures.

We welcome submissions of original research studies on childhood atopic dermatitis or inflammatory skin disease for this Special Issue.

Prof. Dr. Regina Fölster-Holst
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • childhood atopic dermatitis
  • impaired quality of life
  • pruritus
  • biologics
  • JAK-inhibitors
  • prevention

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Published Papers (4 papers)

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Research

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15 pages, 1091 KB  
Article
Hypogammaglobulinemia in Children with Atopic Dermatitis
by Zuhal Karali, Yasin Karali, Zeynep Senocak and Sara Sebnem Kilic
Children 2026, 13(5), 696; https://doi.org/10.3390/children13050696 - 19 May 2026
Viewed by 132
Abstract
Background and aims: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease among children. Our study aimed to evaluate the prevalence of hypogammaglobulinemia among pediatric patients with AD and to characterize the clinical and laboratory findings of patients diagnosed with AD [...] Read more.
Background and aims: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease among children. Our study aimed to evaluate the prevalence of hypogammaglobulinemia among pediatric patients with AD and to characterize the clinical and laboratory findings of patients diagnosed with AD and hypogammaglobulinemia. Method: The electronic files of 1850 patients aged 0–18 years diagnosed with AD between 2020 and 2022 in the Pediatric Immunology and Allergy Clinic of Bursa Medical Faculty City Hospital were retrospectively analyzed. During this period, all patients newly diagnosed with atopic dermatitis at our clinic were systematically screened for their serum immunoglobulin (Ig) levels (IgG, IgA, and IgM) at the time of initial presentation. We included 200 AD patients with hypogammaglobulinemia. Disease severity was classified using the Scoring Atopic Dermatitis (SCORAD) index. Multivariate logistic and linear regression analyses were performed to identify independent determinants of disease severity, considering age, sex, eosinophil counts, total IgE, food allergies, and baseline immunoglobulin levels. Results: The prevalence of hypogammaglobulinemia among the 1850 screened children with AD was 10.8% (200/1850). Of the 200 patients included in this study, 128 (64%) were male, and 72 (36%) were female. The median age at first clinic presentation was 8 months (interquartile range (IQR) 25–75%: 5–16). According to the Scoring Atopic Dermatitis (SCORAD) index, AD severity was mild in 150 (75%) patients and moderate-to-severe in 50 (25%). Food allergy sensitization was present in 72 (36%) patients. Patients with moderate-to-severe AD had significantly lower IgG (300 vs. 374 mg/dL; p < 0.001; r = −0.346), IgA (10 vs. 14 mg/dL; p = 0.004), and IgM (38 vs. 51 mg/dL; p = 0.001) levels when compared with those with mild disease. Multivariate logistic regression confirmed that lower IgG was the only immunoglobulin independently associated with moderate-to-severe AD (OR = 1.97 per 100 mg/dL decrease; 95% CI: 1.15–3.39; p = 0.013), while food allergy was the strongest independent predictor of the SCORAD index (β = +11.97; p < 0.001). None of the patients received intravenous immunoglobulin (IVIG) treatment. Of the 142 patients who underwent serial serum immunoglobulin measurements, 56 (39%) achieved age-appropriate normal IgG levels, while hypogammaglobulinemia persisted in 86 (61%). Conclusions: We found a higher frequency of hypogammaglobulinemia in patients with AD in our study, as compared with previously reported rates of THI in children from the general pediatric population. Although our study showed an increase in IgG levels during the follow-up period in many patients, it emphasizes the need for long-term immunological monitoring, especially in patients with moderate-to-severe AD. Full article
(This article belongs to the Special Issue Childhood Atopic Dermatitis: Diagnosis, Treatment and Management)
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10 pages, 253 KB  
Article
Real-World Treatment Patterns and Determinants of Therapy in Pediatric Atopic Dermatitis: A 10-Year Experience from a Tertiary Referral Center in Thailand
by Nuttida Yusakda, Leelawadee Techasatian, Piyadarat Asawasakulchokedee, Rattapon Uppala, Phanthila Sitthikarnkha, Suchaorn Saengnipanthkul, Prapassara Sirikarn and Pope Kosalaraksa
Children 2026, 13(3), 385; https://doi.org/10.3390/children13030385 - 9 Mar 2026
Viewed by 596
Abstract
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease in children requiring long-term management, yet real-world data on treatment patterns remain limited. Objective: To evaluate treatment trends and factors associated with topical non-steroidal medication use in pediatric AD. Methods: We retrospectively analyzed [...] Read more.
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease in children requiring long-term management, yet real-world data on treatment patterns remain limited. Objective: To evaluate treatment trends and factors associated with topical non-steroidal medication use in pediatric AD. Methods: We retrospectively analyzed 3982 children with AD treated at a tertiary referral center in Thailand between 2015 and 2024. Demographic data, healthcare coverage, and prescribed treatments were reviewed. Multivariable logistic regression was used to identify factors associated with topical non-steroidal use. Results: The median age was 7 years, with no sex difference. The most commonly prescribed treatments were antihistamines (75.0%), topical corticosteroids (47.6%), moisturizers (43.9%), systemic immunosuppressants (15.7%), topical non-steroidal agents including topical calcineurin inhibitors, phosphodiesterase-4 inhibitors, and Janus kinase (JAK) inhibitors (12.7%), and biologics (0.1%). Moderate-potency corticosteroids predominated. Adolescents were less likely to receive topical non-steroidal agents than infants (OR 0.66, 95% CI 0.50–0.87), whereas patients under the Civil Servant Medical Benefit Scheme (CSMBS) had higher access than those under the Universal Coverage Scheme (UCS) (OR 8.40, 95% CI 5.76–12.25). Conclusions: Pediatric AD management was dominated by conventional therapies, with limited access to advanced treatments. Age and healthcare coverage strongly influenced prescribing patterns, highlighting the need for more equitable access. Full article
(This article belongs to the Special Issue Childhood Atopic Dermatitis: Diagnosis, Treatment and Management)
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17 pages, 1065 KB  
Article
Impact of Atopic Dermatitis on the Quality of Life of Children in Ethiopia: A Multicenter Prospective Cohort Study
by Abraham Getachew Kelbore, Wendemagegn Enbiale, Jacqueline M. van Wyk, Efa Ambaw Bogino, Aldo Morrone and Anisa Mosam
Children 2026, 13(2), 201; https://doi.org/10.3390/children13020201 - 31 Jan 2026
Viewed by 798
Abstract
Background: Atopic dermatitis (AD) is a chronic, pruritic and relapsing inflammatory skin disorder affecting children’s quality of life (QoL). Despite rising global prevalence, data on its impact on QoL in low-resource settings remain limited. This study aimed to assess the impact of AD [...] Read more.
Background: Atopic dermatitis (AD) is a chronic, pruritic and relapsing inflammatory skin disorder affecting children’s quality of life (QoL). Despite rising global prevalence, data on its impact on QoL in low-resource settings remain limited. This study aimed to assess the impact of AD and associated factors on the QoL of children and assesses the effect of educational intervention in Ethiopia. Methods: A prospective cohort study was conducted among 461 AD children and their caregivers across four randomly selected hospitals dermatology clinics in Ethiopia from October 2022 to March 2024. Assessments included AD Severity using Scoring Atopic Dermatitis (SCORAD), Infants’ Dermatitis Quality of Life Index (IDLQI) for children aged 0–4, and Children’s Dermatology Life Quality Index (CDLQI) for children aged 5 to 16. Participants received educational guidance from trained nurses during follow-up beyond routine AD treatment. Trained personnel collected clinical and sociodemographic data. AD severity and QoL were reassessed after 6 months. Descriptive, univariate, and linear regression analyses identified factors influencing QoL, with associations reported as odds ratios (95% CI) and significance set at p < 0.05. Results: Of 461 children, 424 (92%) completed follow-up. Most were under five (67%) with a median age of 3 years; 72.2% had AD onset before age two. Most caregivers were female (68.9%). After six months, clinical signs of AD, including dryness, erythema, excoriation, and lichenification, improved notably. Mild AD increased by 33.5%, while moderate and severe cases decreased by 17.5% and 16%, respectively. QoL significantly improved across all domains (p = 0.001). Baseline disease severity (β = 0.11), change in severity (ΔSCORAD) (β = 0.043), number of dependents (β = −0.71), and age at disease onset (β = 0.005) as significant predictors of QoL. Conclusions: AD significantly impairs QoL in Ethiopian children, with greater severity causing more disruption. Routine treatments with educational interventions significantly improve disease severity and QoL. Integrated clinical and psychosocial care approaches for pediatric AD are crucial in resource-limited settings. Full article
(This article belongs to the Special Issue Childhood Atopic Dermatitis: Diagnosis, Treatment and Management)
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Review

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16 pages, 2588 KB  
Review
Atopic Dermatitis in Children: Differential Diagnosis and Mimickers
by Beyza Türe Avcı, Tubanur Çetinarslan, Aylin Türel Ermertcan and Regina Fölster-Holst
Children 2026, 13(5), 690; https://doi.org/10.3390/children13050690 - 18 May 2026
Viewed by 247
Abstract
Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory dermatosis that is characterized by pruritus, xerosis, and age-dependent clinical heterogeneity. Accurately diagnosing AD remains challenging due to the absence of specific biomarkers and the broad spectrum of conditions that may mimic its presentation. [...] Read more.
Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory dermatosis that is characterized by pruritus, xerosis, and age-dependent clinical heterogeneity. Accurately diagnosing AD remains challenging due to the absence of specific biomarkers and the broad spectrum of conditions that may mimic its presentation. A wide range of inflammatory, infectious, and genetic disorders resemble AD, including seborrheic dermatitis, psoriasis, contact dermatitis, scabies, dermatophytosis, and nummular eczema, as well as rare immunodeficiency and metabolic conditions. This review summarizes the evolution of the clinical features of pediatric AD across infancy, childhood, and adolescence, with a focus on key differential diagnoses. Recognizing age-specific patterns and potential mimickers is essential for improving diagnostic accuracy and guiding appropriate management in pediatric AD. Methods: This study was designed as a narrative review. A structured literature search was conducted of PubMed/MEDLINE for studies published between January 2001 and March 2026 using predefined keywords related to AD, childhood, diagnosis, and differential. Clinical trials, randomized controlled trials, systematic reviews, meta-analyses, and guidelines or consensus documents were included. Studies focusing exclusively on adults or lacking clinical relevance were excluded. A qualitative synthesis was performed due to the heterogeneity in study designs and outcomes. Results: This review demonstrates that pediatric atopic dermatitis exhibits marked age-dependent clinical heterogeneity, with distinct morphological features and lesion distribution patterns across infancy, childhood, and adolescence. Furthermore, the substantial clinical overlap with a broad spectrum of inflammatory, infectious, and genetic disorders—combined with the absence of specific diagnostic biomarkers—significantly complicates accurate differential diagnosis and increases the risk of misclassification. Conclusions: The recognition of age-specific patterns and potential mimickers is essential for improving diagnostic accuracy and guiding appropriate management in pediatric AD. Full article
(This article belongs to the Special Issue Childhood Atopic Dermatitis: Diagnosis, Treatment and Management)
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