Overview of atopic dermatitis

Current Review  Open Access

|    Asia Pac Allergy. 2013 Apr;3(2):79-87. English. Published online 2013 April 26.  http://dx.doi.org/10.5415/apallergy.2013.3.2.79  Copyright © 2013. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. Overview of atopic dermatitis Kyu Han Kim Department of Dermatology, Seoul National University Hospital, Seoul 110-744, Korea.  Correspondence: Kyu Han Kim. Department of Dermatology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-3643, Fax: +82-2-747-0611, Email: kyuhkim@snu.ac.kr  Received March 27, 2013; Accepted March 31, 2013. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Atopic dermatitis (AD) is a very common chronic disease that reportedly affects 10%-20% of the general population. The prevalence of AD appears to be steadily increasing, at least in developing countries. Two pathogenetic mechanisms have been mentioned. Traditionally immunological aberrations are thought to be a primary event in the initial development of AD ("inside-to-outside hypothesis"). Another hypothesis assumes that there is an intrinsic defect in epidermal barrier. Due to this barrier defect, allergens or irritants can easily penetrate the epidermal barrier, and induce immunologic reaction secondarily ("outside-to-inside hypothesis"). These days the epidermal barrier defect seems to gain more support as a primary event than immunological aberrations in the early changes of AD since the filaggrin mutation was reported in AD patients. Clinically AD initially affects face, and with age, flexural areas are typically involved. AD has many different clinical features. Diagnostic criteria for AD in each country may be a little different, although based on the criteria proposed by Hanifin and Rajka. AD can be controlled effectively with topical and/or systemic treatments and fortunately spontaneously disappears with age. However, in some cases very resistant to conventional therapies, additional treatments such as immunosuppressive agents are needed. Keywords: Atopic dermatitis, Prevalence, Immunological aberrations, Epidermal barrier defect, Filaggrin mutation.      |