Heterogeneity of Presentation

In darker skin colors, erythema can be difficult to discern, or it may appear violaceous or gray.

Pigmentary changes (dyschromia) are more prominent in darker skin colors; postinflammatory hyperpigmentation may be subtle in very light skin colors.

Papular patterns of AD (ie, follicular eczema) are more common in persons with darker skin phototypes. Inflammatory papules may be seen instead of plaques or scale.

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  Erythema and lichenification on the posterior neck

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  Subtle hyperpigmentation of the skin in an eczema patient

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  Papular patterns of atopic dermatitis (ie, follicular eczema)