<prompt> Dennie Morgan folds are seen in?Dermatitis herpetiformisErytrhema multiformieMeaslesAtopic dermatitis  <response>: Ans. D. Atopic dermatitis Ref. IADVL 2nd433, 416-427; Rooks 7th18.1 - 18.30Dennie Morgan fold is a single or double fold in the lower eyelid, may be due to eyelid edema caused by eyelid dermatitis. It is seen as associated feature in atopic dermatitis.Atopic dermatitis Is an eczema characterized by intense itching and relapsing course in infants and children with a personal or family ho atopic disorders. Coexists with asthma or rhinitis in 80 cases. 70 of patients have family ho atopy. Genetically transmitted Immunological dysfunction and 80 have raised total IgE. Itching is the basic symptom.1Infantile phase Upto 2 yrs. Appears usually at or after 3 months of age. Initial lesions are illdefined erythematous patches on the cheeks. Later spread to scalp, upper trunk and extensor aspect of lower limbs.2Childhood phase Flexural involvement is characteristic antecubital and popliteal fossa Presence of extensor involvement denotes poor prognosis.3Adolescent phase Lichenification is main feature Involvement of face, neck, flexures and upper trunk is characteristic. Excoriation due to scratching are important manifestation.Perioral pallor, pallor at nose and ears Head light sign and dermographism are characteristic of atopic dermatitis.Associated features: Xerosis, Ichthyosis P.alba, Dennie-Morgan fold0 Periorbital darkening Cataract Keratoconus Lipstick cheilitis Hand and foot eczema Management:1 First line therapy Emollients Topical steroids Topical antiinfectives Antihistaminics2 Second line therapy Systemic steroids Immunomodulators azathioprine, cyclosporine, interferons, tacrolimus PhototherapyAdditional Educational points:Iris or target lesions Erythema multiformieBulla spread sign and Nikolskys sign Pemphigus vulgaris.Auspitz sign Plaque Psoriasis.Darriers sign Urticaria pigmentosa.White dermographism Atopic dermatitis.Dimple sign Dermatofibroma. 