Infections Common With Atopic Dermatitis

The red, cracked, and unbearably itchy skin that develops when atopic dermatitis (AD) flares is not only uncomfortable. It also makes one more susceptible to infection.

Research shows that about 90% of people with AD have the Staphylococcus aureus (staph) bacteria present on their skin. By comparison, less than 5% of people without AD have staph on their skin. When a person with AD scratches, the skin often breaks. This allows microorganisms on the skin, such as bacteria, viruses, and fungi, to enter the body. Additionally, a study shows that people with AD cannot produce effective amounts of two natural antibiotic proteins that the immune system needs to fight infection. With staph constantly present on the skin and the immune system unable to adequately fight infection, it is easy to see why people with AD develop infections when their skin flares and they scratch.

Children and teens with AD are especially prone to developing skin infections caused by staph (bacteria) and herpes simplex (virus). Fungal infections may also occur. It is important to recognize the signs and symptoms of infection, and consult your dermatologist as soon as they appear. An untreated infection may be the reason AD does not respond to treatment.

Signs and symptoms to watch for are:
Honey-colored crusting and pus-filled blisters. When a bacterial infection, such as one caused by staph, occurs, honey-colored crusts usually form. This is a sign of infection. Another sign is the appearance of pus-filled blisters that form over patches of AD. These blisters may pop, weep, and form crusts.
Redness. When the skin becomes infected with bacteria, it becomes very red. Widespread red scaly patches and plaques that may crust and discharge pus, usually indicate a staph infection. Streaking or spreading redness also indicates infection.
Swelling/Inflammation. If the area feels enlarged or unusually warm, it may be infected.
Fever. When infection develops, the body’s temperature sometimes rises to create an unfavorable environment for the microorganisms, such as bacteria, viruses, or fungi, causing the infection.

Lesions that resemble cold sores or fever blisters. These may be signs of eczema herpeticum, a viral infection that also causes cold sores. Eczema herpeticum can spread rapidly. In the early stages, you will see numerous small blisters filled with clear fluid that are surrounded by bright red halos. Within one or two days, the blisters will break, leaving small round breaks in the surface of the skin. The skin may become very sore, and the patient will feel quite ill.

Even a person with mild AD can develop a severe infection from the virus. For this reason, it is important to seek medical attention if you see these signs. In rare cases, eczema herpeticum can be life-threatening.

Be sure to keep children with AD away from anyone who has a cold sore.