Atopic Dermatitis
Vincent S. Beltrani, MD, Mark Boguneiwicz, MD
Posted: 05/02/2003; Dermatology Online Journal. 2003;9(2) © 2003 Arthur C. Huntley, MD
From Dermatology Online Journal
Atopic Dermatitis
Vincent S. Beltrani, MD, Mark Boguneiwicz, MD
Posted: 05/02/2003; Dermatology Online Journal. 2003;9(2) © 2003 Arthur C. Huntley, MD
Abstract and Introduction
· Epidemiology of Atopic Dermatitis
Abstract and Introduction
Abstract
Atopic dermatitis, the dermatologic manifestation of the atopic diathesis, has a variety of clinical presentations. This disease probably should be considered a syndrome -- a group of signs and symptoms that frequently occur together in an identifiable pattern. The following update describes the spectrum of atopic dermatitis and summarizes current thinking about the etiology of the disease.
Introduction
Atopic dermatitis (AD), with its variable clinical presentations and course, constitutes a syndrome made up of an identifiable group of signs and symptoms that represents the dermatological manifestation of the atopic diathesis.
Despite some minor discrepancies and limitations in diagnosing AD, epidemiological studies continue to note AD as a fairly common problem, which in the past half century, has become more prevalent.[1,2] This increase in atopic diseases has been rationalized by a "hygiene hypothesis," which attributes the propensity toward the atopic-associated diseases to reduced microbial exposure in early life, especially in developed countries.[3] This increasing occurrence of AD, compounded by the managed-care mandate to deter specialists' consultations, subjects these patients to being managed by clinicians with less expertise. Despite the high incidence of AD, at a recent (January 2001) Consensus Conference on Pediatric Atopic Dermatitis, sponsored by the American Academy of Dermatology, 40 select physicians, including dermatologists and allergists (excluding pediatricians and other primary-care physicians), were only able to reach a weak consensus regarding the diagnosis, treatment, and required future research. Another, industry-sponsored (Novartis) conference, the International Consensus Conference on Atopic Dermatitis (ICCAD) held in New Orleans in February 2002, aspired to develop international guidelines, outlining current and forthcoming therapeutic options for the treatment of atopic eczema. They announced a consensus regarding the status of atopic eczema and overall treatment guidelines for atopic eczema. Even terminology has not become uniform. In Britain, AD is often referred to as atopic eczema (intrinsic and extrinsic types).Ironically, there is some rationale to each of the proclaimed conclusions, and, because of the lack of a universal immunologic endorsement for all the differences, a general consensus will continue to evade us. The authors, a dermatologist-allergist (VSB) and an allergist (MB) intend to present objectively the current, significant available data regarding AD.