Atopic dermatitis - itchy problem of children and adults
DOI:
https://doi.org/10.12775/JEHS.2024.59.004Keywords
atopic dermatitis, skin itching, emollients, glucocorticosteroids, Hanifin and Rajka criteriaAbstract
Atopic dermatitis is a chronic inflammatory disease with recurrent exacerbations, persistent itching, erythema, dry skin due to damage to the epidermal barrier, and staphylococcal infections. The causative factors are mutations in the gene encoding filaggrin, dysregulation of the immune system, changes in the skin microbiome and lipids in the stratum corneum and deficiency of antimicrobial peptides AMPs. The disease mainly affects children, causing a significant deterioration in the quality of life, and its first symptoms occur in approximately 90% before the age of 5. Lesions most often appear on the bends of elbows and knees, on the face and neck, but may also affect the skin of the entire body (erythroderma). The location of the eruptions depends on age. Atopic dermatitis is the result of complex genetic, epigenetic, environmental and immunological interactions with a coexisting epidermal barrier defect. The disease is diagnosed based on the Hanifin and Rajka criteria. Treatment of atopic dermatitis is symptomatic and selected individually. They include the elimination of provoking factors, care of the epidermal barrier, and anti-inflammatory and anti-pruritic therapy.
References
Fishbein AB, Silverberg JI, Wilson EJ, et al. Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection. J Allergy Clin Immunol Pract 2020;8(1):91-101. doi 10.1016/j.jaip.2019.06.044
Silverberg JI. Adult-Onset Atopic Dermatitis. J Allergy Clin Immunol Pract 2019;7(1):28-33. doi: 10.1016/j.jaip.2018.09.029
Vakharia PP, Silverberg JI.Epidemiology of Adult-Onset Atopic Dermatitis: Characteristics and Management. Am J Clin Dermatol 2019;20(6):771-9. doi: 10.1007/s40257-019-00453-7
Sacotte R, Silverberg JI. Epidemiology of adult atopic dermatitis. Clin Dermatol 2018;36(5):595-605. doi: 10.1016/j.clindermatol.2018.05.007
Kezic S, Kemperman PM, Koster ES, et al. Loss-of-function mutations in the filaggrin gene lead to reduced level of natural moisturizing factor in the stratum corneum. J Invest Dermatol 2008;128(8):2117-9. doi: 10.1038/jid.2008.29. Erratum in: J Invest Dermatol 2008;128(6):1604
Zeeuwen PL, Kleerebezem M, Timmerman HM, et al. Microbiome and skin diseases. Curr Opin Allergy Clin Immunol 2013; 13:514-20
Suárez AL, Feramisco JD, Koo J, et al. Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates. Acta Derm Venerol 2012;92(1):7-15. doi: 10.2340/0001555-1188
Arima M, Shimizu Y, Sowa J, et al. Psychosomatic analysis of atopic dermatitis using a psychological test. J Dermatol 2005;32(3):160-8. doi: 10.1111/j.1346-8138.2005.tb00738.x
Takai H, Ishii Y. Sense of coherence, depression, and anger among adults with atopic dermatitis. Psychol Health Med. 2013;18(6):725-34. doi: 10.1080/13548506.2013.766353
Kim SH, Hur J, Jang JY, et al. Psychological Distress in Young Adult Males with Atopic Dermatitis: A Cross-Sectional Study. Medicine (Baltimore) 2015;94(23):e949. doi: 10.1097/MD.00000000000000949
Sakazaki F, Ogino H, Arakawa T, et al. Low-dose ethanol aggravates allergic dermatitis in mice. Alcohol 2014;48(5):501-8. doi: 10.1016/j.alcohol.2014.05.001
Lee CH, Chuang HY, Hong CH, et al. Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br J Dermatol 2011;164(3):483-9. doi: 10.1111/j.1365-2133.2010.10116.x
Eberlein-Köning B, Przybilla B, Kühnl P, et al. Influence of airborne nitrogen dioxide or formaldehyde on parameters of skin function and cellular activation in patients with atopis eczema and control subjects. J Allergy Clin Immunol 1998;101(1 Pt 1):141-3. doi: 10.1016/S0091-6749(98)70212-X
Kelso JM. Atopic Diseases, Allergic Sensitization, and Exposure to Traffic-Related Air Pollution in Children. Pediatrics 2009;124 (Suppl 2):S116
Asher Ml, Keil U, Anderson HR, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 1995;8(3):483-91. doi: 10.1183/09031936.95.08030483
Hanifin JM, Thurston M, et al. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol 2001;10(1):11-8. doi: 10.1034/j.1600-0625.2001.100102.x
Koćwin M., Kuna P.: Biological drugs in the treatment of difficult patients with atopic dermatitis. Therapy, 2017; 4(351): 92–97
Bożek A, Reich A.: Methods of assessing the severity of atopic dermatitis. Overview Dermatol., 2016; 103: 479–485
Loden M. Increased skin hydration after using emollients with different lipid content. Acta Derm Venereol. 1992; 72: 327–330. [PubMed] [Google Scholar]
Sidbury R, Davis DM, Cohen DE et al. Guidelines for the treatment of atopic dermatitis. Part 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014; 71: 327–49. [ PMC free article ] [ PubMed ] [ Google Scholar ] [ Reference list ]
Huang JT, Abrams M, Tlougan B, et al. Treatment of Staphylococcus aureus colonization in atopic dermatitis reduces the severity of the disease. Pediatrics. 2009; 123 :e808–14. [PubMed] [Google Scholar]
Wollenberg A, Barbarot S, Bieber T et al. Consensus-based European guidelines for the treatment of atopic eczema (atopic dermatitis) in adults and children: Part I. J Eur Acad Dermatol Venereol. 2018; 32 :657–82. [PubMed] [Google Scholar]
Contemporary dermatology Lidia Rudnicka, Małgorzata Olszewska, Adriana Rakowska, Marta Sar-Pomian, PZWL 2022; 34, 192-197
Lebwohl MG, Del Rosso JQ, Abramovits W, et al. Pathways to managing atopic dermatitis: consensus from the experts. J Clin Aesthet Dermatol. 2013;6(7 Suppl):S2–18. [PMC free article] [PubMed] [Google Scholar]
Wollenberg A, Oranje A, Deleuran M et al. 2015 ETFAD/EADV Eczema Task Force Position Paper on the diagnosis and treatment of atopic dermatitis in adult and pediatric patients. J Eur Acad Dermatol Venereol. 2016; 30 :729–47. [PubMed] [Google Scholar].
Sidbury R, Davis DM, Cohen DE et al. Guidelines for the treatment of atopic dermatitis. Part 3. Management and treatment
Gupta A.K, Chow M.: Pimecrolimus: a review. J. Eur. Acad. Dermatol. Venereol. 2003, 17(5): 493–50.
Silny W.: The use of calcineurin inhibitors in dermatological treatment. Conductor Bow. 2006, 7, 54–60
Nowicki RJ, TrzeciakM., Rudnicka L., Szepietowski J., Kulus M., Kupczyk M. et al.: Biological drugs in the treatment of atopic dermatitis - recommendations of the Polish Society of Dermatology, Polish Society of Allergology, Pedia Polska - Society of Family Medicine and Polish Society of Family Medicine . Dermatol Rev 2020, 107, 409-42
Guttman-Yassky E., Thai D., Pangan AL, Hong HCH, Papp KA, ReichK. et.al.: Upadacitinib in adults with moderate to severe atopic dermatitis: Results after 16 weeks from a randomized, placebo-controlled study.J. AlergiaClin Immunol 2020, 145,877-884.
Simpson EL, Parnes JR, Ona D., Crouch S., ReesW., Mo M., et al.: Tezepelumab, antithymic stromal lymphopoietin monoclonal antibody, treatment of moderate to severe atopic dermatitis: a randomized phase 2a clinical trial. JJest AcadDermatol 2019, 80, 1013-1021
Guttman-Yassky E., Silverberg JI, Nemoto O., FormanSB, Wilke A., Prescilla R., et al.: Baricitinib in adult patients with moderate to severe atopic dermatitis: a phase 2 parallel, double-blind, randomized, placebo-controlled study with using multiple doses. J Am Acad Dermatol 2019, 80, 913-921.e9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nina Lasota, Gabriela Demidowicz, Natalia Trąbka, Patryk Lasek, Maciej Smerdzyński, Katarzyna Łach, Kinga Ściurka, Klaudia Kowalczyk, Kinga Panuciak, Karolina Kozicka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 293
Number of citations: 0