Associations between atopic dermatitis and other disorders

Silverberg, Jonathan I.

doi:10.12688/f1000research.12975.1

Cited by 33 publications

(32 citation statements)

References 68 publications

(91 reference statements)

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“…Itchy skin, especially at night, results in sleep disturbance and fatigue, as well as mental health symptoms. 2,7,9,18,23,29 There is no specific diagnostic test or pathognomonic laboratory biomarker for AD diagnosis, which is established by characteristic clinical features, pruritus, disease evolution and a personal and/or family history of atopy. 6,14,25 The most typical feature, the elevation of total or allergen-specific IgE levels in serum, is not present in all individuals, presumably distinguishing two forms of the disease, the non-IgE-associated ('intrinsic') AD and the IgE-associated ('extrinsic') AD.…”

Section: Clinical Features and Diagnosticmentioning

confidence: 99%

“…2,4,5,12,18 Remarkably in children, sleep disturbances may be related with growth impairment, lower school performance, attention deficit hyperactivity disorders, and higher accident risks. 9 Potentially under-recognized AD non-allergic comorbidities include cutaneous and extra-cutaneous infections, other autoimmune-or immune-mediated diseases, neuropsychiatric conditions, and emerging comorbidities, such as obesity, cardiovascular and metabolic diseases, as well as specific cancers. 2,[5][6][7]9,13,14,18,25,27 The causative mechanisms underlying these associations are largely unknown, and the absolute magnitude of the risks has not been well defined.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…9 Potentially under-recognized AD non-allergic comorbidities include cutaneous and extra-cutaneous infections, other autoimmune-or immune-mediated diseases, neuropsychiatric conditions, and emerging comorbidities, such as obesity, cardiovascular and metabolic diseases, as well as specific cancers. 2,[5][6][7]9,13,14,18,25,27 The causative mechanisms underlying these associations are largely unknown, and the absolute magnitude of the risks has not been well defined. 5 Many of these comorbid conditions are directly related to the underlying severity of AD and inadequate disease control.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…1,2,[5][6][7][8] AD often develops during childhood, and has a wide spectrum of symptoms and signs which contribute towards profound functional disturbances, limits the ability to perform daily life activities and causes psychosocial distress and stigma. 2,9 The psychosocial and financial implications of AD affect patients, their families, health care providers, and society in general. 1,5,8 Torres T, et al Update on atopic dermatitis, Acta Med Port 2019 Sep; 32(9): [606][607][608][609][610][611][612][613] The pathophysiological concepts underlying AD have shifted towards an integrated view, in which genetic and environmental factors interact contributing to varying degrees of epidermal barrier disruption, activation of different T cell subsets, and commensal skin microbiota dysbiosis, causing the varying clinical presentations, presumably encompassing a variety of subtypes with distinct and overlapping pathological mechanisms.…”

Section: Introductionmentioning

confidence: 99%

“…2 Although the underlying mechanisms causing these conditions are largely unknown and the absolute magnitude of the risks has not yet been well defined, AD has been considered more recently as a systemic disorder associated with increased risk of various allergic and non-allergic comorbidities, namely food allergies, respiratory disorders, cutaneous and extra-cutaneous infections, neuropsychiatric conditions, other inflammatory and autoimmune diseases, lymphoma, and cardiovascular disease, with important implications for management and treatment. 1,2,5,6,[9][10][11][12][13] Therapeutic goals require a multistep approach, focused on reducing pruritus and establishing disease control. Treatment selection is based primarily on disease severity but also on the patient's age, comorbidities, compliance, and costs.…”

Section: Introductionmentioning

confidence: 99%

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Update on Atopic Dermatitis

Torres¹,

et al. 2019

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With an increasing prevalence during the past decades, atopic dermatitis has become a global health issue. A literature search following a targeted approach was undertaken to perform this non-systematic review, which intends to provide an overview of the epidemiology, pathophysiology, clinical features, comorbidities, and current therapies for the treatment of atopic dermatitis. In sum, this is a heterogeneous skin disorder associated with variable morphology, distribution, and disease course. Although not completely understood, its pathogenesis is complex and seems to result from a combination of genetic and environmental factors that induce skin barrier dysfunction, cutaneous and systemic immune dysregulation, skin microbiota dysbiosis, and a strong genetic influence. Diagnosis is based on specific criteria that consider patient and family history and clinical manifestations. Overall disease severity must be determined by evaluating both objective signs and subjective symptoms. Therapeutic goals require a multistep approach, focusing on reducing pruritus and establishing disease control. Patients should be advised on basic skin care and avoidance of triggers. Topical anti-inflammatory agents should be considered in disease flares or chronic/recurrent lesions. In case of inadequate response, phototherapy, systemic immunosuppressants and, more recently, dupilumab, should be added. Nevertheless, the treatment of moderate-to-severe atopic dermatitis remains challenging and novel, efficacious, safe and targeted treatments are urgently needed. In conclusion, although the last few years have seen important improvement in the understanding of the disease, future research in atopic dermatitis will continue exploring gene-environment interactions and how it affects pathophysiology, disease severity, and treatment outcomes.

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