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Phenotypes of atopic dermatitis.

Abstract

Atopic dermatitis (AD) is a common disease affecting both children and adults. AD develops from a complex interplay between environmental, genetic, immunologic and biochemical factors. Genetic factors predispose atopic subjects to mount exaggerated Th2 responses and to a poorly efficient epidermal barrier, which may be sufficient to initiate inflammation in the skin and may favor allergic sensitization. Thus AD can present with different clinical pheno-types. AD is classically distinguished into an intrinsic and extrinsic form, which are clinically identical but the former lacks high level specific IgE and is not associated with respiratory atopy. Although in many cases AD presents with monotonous eczematous lesions on the face, neck and skin folds, it may also present with other features. Very common is nummular eczema, which in many instances may be the dominant expression of AD. In other patients, AD affects limited areas (periorificial eczema, nipple eczema, cheilitis, hand eczema) or its main presentation is with excoriated papules and nodules (atopic prurigo). In conclusion, AD is a multifaceted disease affecting patients with epidermal barrier dysfunction and dry and sensitive skin. The recognition of the less common AD phenotypes is essential for proper patient management.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Section of Dermatology and Venereology, University of Verona, Italy.

    , ,

    Source

    MeSH

    Adult
    Dermatitis, Atopic
    Diagnosis, Differential
    Humans
    Phenotype
    Terminology as Topic

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng ger

    PubMed ID

    21054785

    Citation

    Pugliarello, Silvia, et al. "Phenotypes of Atopic Dermatitis." Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, vol. 9, no. 1, 2011, pp. 12-20.
    Pugliarello S, Cozzi A, Gisondi P, et al. Phenotypes of atopic dermatitis. J Dtsch Dermatol Ges. 2011;9(1):12-20.
    Pugliarello, S., Cozzi, A., Gisondi, P., & Girolomoni, G. (2011). Phenotypes of atopic dermatitis. Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 9(1), pp. 12-20. doi:10.1111/j.1610-0387.2010.07508.x.
    Pugliarello S, et al. Phenotypes of Atopic Dermatitis. J Dtsch Dermatol Ges. 2011;9(1):12-20. PubMed PMID: 21054785.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Phenotypes of atopic dermatitis. AU - Pugliarello,Silvia, AU - Cozzi,Alessandra, AU - Gisondi,Paolo, AU - Girolomoni,Giampiero, Y1 - 2010/11/04/ PY - 2010/11/9/entrez PY - 2010/11/9/pubmed PY - 2011/4/19/medline SP - 12 EP - 20 JF - Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG JO - J Dtsch Dermatol Ges VL - 9 IS - 1 N2 - Atopic dermatitis (AD) is a common disease affecting both children and adults. AD develops from a complex interplay between environmental, genetic, immunologic and biochemical factors. Genetic factors predispose atopic subjects to mount exaggerated Th2 responses and to a poorly efficient epidermal barrier, which may be sufficient to initiate inflammation in the skin and may favor allergic sensitization. Thus AD can present with different clinical pheno-types. AD is classically distinguished into an intrinsic and extrinsic form, which are clinically identical but the former lacks high level specific IgE and is not associated with respiratory atopy. Although in many cases AD presents with monotonous eczematous lesions on the face, neck and skin folds, it may also present with other features. Very common is nummular eczema, which in many instances may be the dominant expression of AD. In other patients, AD affects limited areas (periorificial eczema, nipple eczema, cheilitis, hand eczema) or its main presentation is with excoriated papules and nodules (atopic prurigo). In conclusion, AD is a multifaceted disease affecting patients with epidermal barrier dysfunction and dry and sensitive skin. The recognition of the less common AD phenotypes is essential for proper patient management. SN - 1610-0387 UR - https://www.unboundmedicine.com/medline/citation/21054785/full_citation L2 - https://doi.org/10.1111/j.1610-0387.2010.07508.x DB - PRIME DP - Unbound Medicine ER -