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Chapter 13 – Atopic Dermatitis

Kefei Kang,
Amy M Polster,
Susan T Nedorost,
Seth R Stevens,
Kevin D Cooper

      Atopic eczema

Key features

      Chronic, relapsing dermatitis associated with intense pruritus
      Distribution varies in infantile, childhood and adulthood forms; periods of quiescence can occur between stages
      Acute inflammation with extensor and facial involvement is common in infants, whereas both chronic inflammation and localization to flexures increase in prevalence with age
      Often associated with xerosis as well as a personal or family history of atopy (e.g. asthma, allergic rhinitis)
      Genetic basis (e.g. FLG mutations) with variable expression influenced by environmental factors
      Immuno-aberration is evidenced by the common occurrence of serum IgE elevation and eosinophilia; the Th2 predominance in acute lesions evolves into a predominance of IFN-γ-producing T cells in chronic hyperplastic lesions
      Langerhans cells and other dendritic cells that bind IgE result in enhanced T-cell reactivity to …