Epidemiology, clinical features, and immunology of the “intrinsic” (non‐IgE‐mediated) type of atopic dermatitis (constitutional dermatitis)

From Pharaoh Menes to today - allergic diseases are the focus

“…However, the discussion about an appropriate nomenclature for allergic diseases is still a dynamic process. Another insight gained in parallel to the expansion of our diagnostic options to analyze sensitizations is that in a subgroup of patients with allergic diseases, serum IgE levels remain low and no allergen-specific IgE or sensitization is detectable, although these patients present the typical symptoms and the classic clinical picture of allergic disorders [11,12]. These observations were not completely inline with the previous hypothesis that allergic diseases have to be associated with sensitizations against allergens and consequently predominated by IgE-mediated mechanisms.…”

The Efficacy and Safety of Long-term Oral Cyclosporine Treatment for Patients with Atopic Dermatitis

“…In the previous reports on CsA treatment for moderate to severe AD patients, there was no significant gender predominance 9,18 . The frequency of AD patients presenting with intrinsic AD is variable, ranging from 16 to over 25 percent, and up to 45 percent according to different regions 15 . In our study, the frequency of intrinsic AD among all the AD subjects was 24.6%.…”

Atopic eczema/dermatitis syndrome – a genetically complex disease. New advances in discovering the genetic contribution

“…Therefore, the pathogenesis of this nonallergic AEDS [called intrinsic atopic dermatitis by Wu¨thrich, (67)] seems to be different from the disease known as classical allergic form of AEDS (extrinsic atopic dermatitis). According to Schmid-Grendelmeier, Wu¨thrich et al (68), diagnostic criteria should run as follows: (i) a clinical phenotype AEDS, fulfilling the diagnostic criteria of Hanifin and Rajka (69) (ii) low total serum-IgE levels (< 200 kU/l) in combination with negative in-vitro IgE-screening for aeroallergens and food allergens (e.g., negative SX1-RAST and SX-5 RAST) as well as negative prick test results for standard aero-and food-allergens (iii) absence of other atopic diseases such as allergic rhinoconjunctivitis or allergic bronchial asthma. Hence, patients may initially be considered having a nonallergic AEDS, but during the allergologic workup they may need to be reclassified as allergic AECS and vice versa.…”