Clinical differences between atopic and atopiform dermatitis

Brenninkmeijer, E.E.A.; Spuls, Phyllis I.; Legierse, Catharina M.; Lindeboom, Robert; Smitt, J.H. Sillevis; Bos, Jan D.

doi:10.1016/j.jaad.2007.12.002

Cited by 98 publications

(29 citation statements)

References 46 publications

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“…Of patients with AD, 76.3% were found to havethe extrinsic types,whereas the rest (23.7%) had the intrinsic type. Our data seemed consistent with those of previous reports: the incidence of extrinsic vs intrinsic AD in Germany (63% vs 37%),27 in Netherlands (78.2% vs 21.8%),28 and in Korea (80% vs 20%) 29. Comparing the 2 types among different age groups, the proportion was similar between the extrinsic vs intrinsic type in the infancy group (age ≤2 years, 50.8% vs 49.2%), whereas the number of patients with the extrinsic type increased with age, reaching 80.5% in the adolescent and adult groups (age >11 years).…”

Section: Discussionsupporting

confidence: 93%

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Chu

Shin

Park

et al. 2017

Allergy Asthma Immunol Res

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PurposeAtopic dermatitis (AD) is a chronic eczematous dermatitis that has a high prevalence and diverse clinical features. Although several hypotheses about its multifactorial pathogenesis have been suggested, the cause is not yet fully understood. A better understanding of the clinical features may helpful inelucidating the pathogenesis of AD.MethodsThis retrospective study analyzed the questionnaires, medical charts, and laboratory examination results of 5,000 patients diagnosed with AD at a single tertiary hospital in Korea.ResultsThe demographics, allergic comorbidities, family history, severity, and treatment experiences of the patients were analyzed. Most of the patients were adults, 76.3% of whom were classified as havingan extrinsic type of AD. The mean eczema area and severity index (EASI) score was found to be 13.68, and adult patients were found to have higher severity than the other age groups. The anatomical involvements were different among the age groups, with more involvements of the head and neck in adults. The patients reported seasonal changes and stress as the factors that aggravated their symptoms the most. Topical steroids and oral cyclosporine were the most used medications at our clinic, whereas 10.1% of the patients underwent allergen-specific immunotherapy.ConclusionsThis analysis of 5,000 patients would lead to a better understanding of various subtypes and diverse clinical features of AD in Koreans. Distinct characteristics were observed among different age groups; thus, treatment strategies may need to be differentiated accordingly.

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Section: Discussionsupporting

confidence: 93%

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Chu

Shin

Park

et al. 2017

Allergy Asthma Immunol Res

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“…These findings suggest that allergy diagnostics should be performed in elderly patients; however, skin prick tests may not always be reliable when performed on aging skin. On the other hand, we observed contact dermatitis more often in elderly patients with AD compared to values reported in the literature [1,12,13]. Our findings confirmed that 21% of elderly patients had AD with low total IgE and were not allergic to common allergens.…”

Section: Discussionsupporting

confidence: 88%

Clinical Features and Immunological Markers of Atopic Dermatitis in Elderly Patients

Bożek¹,

Fisher²,

Filipowska³

et al. 2011

Int Arch Allergy Immunol

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Background: Atopic dermatitis (AD) is increasing among the elderly. Staphylococcus aureus colonization is one of the most important aggravating factors in AD. Objective: This study analyses the clinical features of AD in elderly patients and determines the pathogenic roles of staphylococcal superantigens in AD with low and high total IgE levels. Methods:S. aureus enterotoxin genes were evaluated using PCR. Additionally, S. aureus-specific IgE levels and peripheral blood lymphocyte profiles were assessed. Results: A total of 44 women and 77 men diagnosed with AD with a mean age of 68.92 ± 6.51 years were evaluated. In 17 (68%) patients with AD and low levels of total IgE, there was a positive correlation between the positive results for enterotoxin B, S. aureus-specific IgE antibodies and Th1 cytokine profiles (Spearman’s rank correlation test, r = 0.89, p < 0.05). Conclusion: Our results indicate that AD patients with low total IgE levels differ in immunopathogenesis from AD patients with high circulating levels of total IgE AD.

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“…A previous study suggested a strong association between filaggrin mutation of the Ichthyosis-related gene and the development of AE in IgE-allergic AE patients [13], while a tendency toward a lower incidence of ichthyosis in IgE-allergic AE compared to non-IgE-allergic AE was reported in another study [14]. In regard to the onset of elderly AE (Figure 1, Table 2), two thirds of overall patients showed senile onset of AE symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…These results may suggest that these three types of elderly AE represent different phenotypes [15,16,17] not only in the serological characteristics but also in the clinical features. However, whether non-IgE-allergic elderly AE patients with early life (childhood, adolescence, or young adulthood) onset had continuously shown a non-IgE-allergic status remains unclear, and the possibility of mild symptom status shifting to IgE-allergic elderly AE could not be ruled out for either non-IgE-allergic elderly AE patients or indeterminate-allergic elderly AE patients [8,14]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics, Treatments, and Prognosis of Atopic Eczema in the Elderly

Tanei

2015

JCM

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Atopic eczema (AE) in the elderly is gradually increasing and has been added to the classification of AE in recent years. This investigation retrospectively analyzed 60 patients with elderly AE. Among the clinical characteristics, a male predominance, existence of several patterns of onset and clinical course, and associations with immunoglobulin (Ig)E-allergic-status and asthmatic complication were observed. The highest positive-rate and positive-score for serum-specific IgE against Dermatophagoides farinae were 83.8% and 2.65 in patients with IgE-allergic AE, and a lower incidence of lichenified eczema in the elbow and knee folds were observed. In terms of treatments and outcomes, clinical improvement and clinical remission were observed in 80.8% and 36.5% of cases, respectively, using standard treatments and combined therapy with oral corticosteroid in severe cases. As for complications and final prognosis, most elderly AE patients reached the end of life with AE, but patients with IgE-allergic AE showed significantly lower incidences of complications of malignancy and death from malignancy. These results indicate that AE in the elderly represents a new subgroup of AE with specific features.

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Clinical differences between atopic and atopiform dermatitis

Cited by 98 publications

References 46 publications

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Clinical Features and Immunological Markers of Atopic Dermatitis in Elderly Patients

Clinical Characteristics, Treatments, and Prognosis of Atopic Eczema in the Elderly

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