Advertisement

Introduction

  • Erica A. FortsonEmail author
  • Becky Li
  • Mahima Bhayana
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1027)

Abstract

Atopic dermatitis (AD) is a chronic relapsing condition that is characterized by itching and redness of the skin. Our modern usage of atopic dermatitis dates back to 1933, when Wise and Sulzberger first coined the term to signify the disease’s close association with other respiratory atopy, such as bronchial asthma and allergic rhinitis. A recent systematic review of 69 cross-sectional and cohort studies has confirmed that AD is now a worldwide phenomenon with lifetime AD prevalences of well over 20% in many affluent country settings. Although there is no obvious consistent overall global trend in the prevalence of AD, studies have shown that climate, urbanization, lifestyle, and socioeconomic class influence the prevalence of atopic dermatitis. Despite the pervasiveness of the disease, an understanding of atopic dermatitis has been hampered by a number of factors. Data suggests that extrinsic environmental factors work in concert with intrinsic immune mechanism and genetic factors to drive disease progression. With such a complex etiology, management of atopic dermatitis currently at best achieves symptomatic control rather than cure. This approach poses a significant burden on healthcare resources, as well as patients’ quality of life. Current management methods of AD often involves a combination of non-pharmacologic modalities and prescription medications. Though they can be effective when employed, there are significant barriers to treatment for patients including time, costs, and medication side effects. Our aim, throughout this text, is to explore the complexities of AD, providing the healthcare provider with tips and tricks to improve patient care and satisfaction and the most current trends and treatment approaches on the horizon.

Keywords

Atopic dermatitis Besnier’s prurigo Atopic eczema Intrinsic allergic dermatitis Neurodermitis constitutionalis Endogenous eczema Eczema flexurarum Asthma-eczema Hay fever-eczema 

References

  1. 1.
    Levy RM, Gelfand JM, Yan AC. The epidemiology of atopic dermatitis. Clin Dermatol. 2003;21(2):109–15.CrossRefPubMedGoogle Scholar
  2. 2.
    Spergel JM. From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol. 2010;105:99–106.CrossRefPubMedGoogle Scholar
  3. 3.
    Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66:8–16.CrossRefPubMedGoogle Scholar
  4. 4.
    Hill LW, Sulzberger MB. Yearbook of dermatology and syphilology. Chicago: Year Book Medical Publishers; 1933. p. 1–70.Google Scholar
  5. 5.
    Besnier EH. Annals of dermatology and syphilography 1892;3:634–648.Google Scholar
  6. 6.
    Sulzberger M. Historical notes on atopic dermatitis: its names and nature. Semin Dermatol. 1983;2:1–4.Google Scholar
  7. 7.
    Nexmand PH. Clinical studies of Besnier’s prurigo. Cophenhagen: Rosenkilde and Bagger; 1948.Google Scholar
  8. 8.
    Larsen FS, Diepgen T, Svensson A. The occurrence of atopic dermatitis in north Europe: an international questionnaire study. J Am Acad Dermatol. 1996;34:760–4.CrossRefGoogle Scholar
  9. 9.
    Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI, Group IPTS. Global variations in prevalence of eczema symptoms in children from ISAAC phase three. J Allergy Clin Immunol. 2009;124:1251–1258.e23.CrossRefPubMedGoogle Scholar
  10. 10.
    Mallol J, Crane J, von Mutius E, Odhiambo J, Keil U, Stewart A. ISAAC phase three study group: the international study of asthma and allergies in childhood (ISAAC) phase three: a global synthesis. Allergol Immunopathol. 2013;41:73–85.CrossRefGoogle Scholar
  11. 11.
    Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR. International study of asthma and allergies in childhood (ISAAC) phase one and three study groups: is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008;121:947–954.e15.CrossRefPubMedGoogle Scholar
  12. 12.
    Deckers IA, McLean S, Linssen S, Mommers M, van Schayck CP, Sheikh A. Investigating international time trends in the incidence and prevalence of atopic eczema 1990–2010: a systematic review of epidemiological studies. PLoS One. 2012;7(7):e39803.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Williams HC. Epidemiology of atopic dermatitis. Clin Exp Dermatol. 2000;25:522–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Agata H, Kondo N, Fukutomi O, Hayashi T, Shinoda S, Nishida T, Yomo A, Suzuki Y, Shimozawa N, Tomatsu S. Comparison of allergic diseases and specific IgE antibodies in different parts of Japan. Ann Allergy. 1994;72:447–51.PubMedGoogle Scholar
  15. 15.
    Pöysä L, Korppi M, Pietikäinen M, Remes K, Juntunen-Backman K. Asthma, allergic rhinitis and atopic eczema in Finnish children and adolescents. Allergy. 1991;46:161–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Leung R, Ho P. Asthma, allergy and atopy in three south-east Asian populations. Thorax. 1994;49:1205–10.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Investig Dermatol. 2013;133:1752–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Miajlovic H, Fallon PG, Irvine AD, Foster TJ. Effect of filaggrin breakdown products on growth of and protein expression by Staphylococcus aureus. J Allergy Clin Immunol. 2010;126:1184–1190.e3.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    George AO. Atopic dermatitis in Nigeria. Int J Dermatol. 1989;28:237–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Schafer T, Kramer U, Vieluf D, Abeck D, Behrendt H, Ring J. The excess of atopic eczema in East Germany is related to the intrinsic type. Br J Dermatol. 2000;143:992–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Sausenthaler S, Kompauer I, Borte M, Herbarth O, Schaaf B, Von Berg A, Zutavern A, Heinrich J. Margarine and butter consumption, eczema and allergic sensitization in children. Pediatr Allergy Immunol. 2006;17:85–93.CrossRefPubMedGoogle Scholar
  22. 22.
    Ellwood P, Asher MI, Garcia-Marcos L, Williams H, Keil U, Robertson C, Nagel G. Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the international study of asthma and allergies in childhood (ISAAC) phase three. Thorax. 2013;68:351–60.CrossRefPubMedGoogle Scholar
  23. 23.
    McNally N, Phillips D. Social factors and atopic dermatitis. In: Williams HC, editor. Atopic dermatitis. Cambridge: Cambridge University Press; 2000. p. 139–47.CrossRefGoogle Scholar
  24. 24.
    Strachan DP. Hay fever, hygiene and household size. Br Med J. 1989;299:1259–60.CrossRefGoogle Scholar
  25. 25.
    Fiset PO, Leung DY, Hamid Q. Immunopathology of atopic dermatitis. J Allergy Clin Immunol. 2006;118:287–90.CrossRefPubMedGoogle Scholar
  26. 26.
    Larsen FS, Holm NV. Atopic dermatitis in a population based twin series. Concordance rates and heritability estimation. Acta Dermato Venereologica. 1985;114:159.Google Scholar
  27. 27.
    Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, Goudie DR, Sandilands A, Campbell LE, Smith FJ, O’Regan GM, Watson RM, Cecil JE, Bale SJ, Compton JG, JJ DG, Fleckman P, Lewis-Jones S, Arseculeratne G, Sergeant A, Munro CS, El Houate B, McElreavey K, Halkjaer LB, Bisgaard H, Mukhopadhyay S, WH ML. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38:441–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Flohr C, Nagel G, Weinmayr G, Kleiner A, Strachan DP, Williams HC. Lack of evidence for a protective effect of prolonged breast-feeding on childhood eczema: lessons from the international study of asthma and allergies in childhood (ISAAC) phase two. Br J Dermatol. 2011;165:1280–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Sariachvili M, Droste J, Dom S, Wieringa M, Hagendorens M, Stevens W, van Sprundel M, Desager K, Weyler J. Early exposure to solid foods and the development of eczema in children up to 4 years of age. Pediatr Allergy Immunol. 2010;21:74–81.CrossRefPubMedGoogle Scholar
  30. 30.
    Snijders BE, Thijs C, van Ree R, van den Brandt PA. Age at first introduction of cow milk products and other food products in relation to infant atopic manifestations in the first 2 years of life: the KOALA birth cohort study. Pediatrics. 2008;122:e115–22.CrossRefPubMedGoogle Scholar
  31. 31.
    Zutavern A, Brockow I, Schaaf B, von Berg A, Diez U, Borte M, Kraemer U, Herbarth O, Behrendt H, Wichmann HE, Heinrich J. Timing of solid food introduction in relation to eczema, asthma, allergic rhinitis, and food and inhalant sensitization at the age of 6 years: results from the prospective birth cohort study LISA. Pediatrics. 2008;121:e44–52.PubMedGoogle Scholar
  32. 32.
    Filipiak B, Zutavern A, Koletzko S, von Berg A, Brockow I, Grubl A, Berdel D, Reinhardt D, Bauer CP, Wichmann HE, Heinrich J. Solid food introduction in relation to eczema: results from a four-year prospective birth cohort study. J Pediatr. 2007;151:352–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Murray CS, Canoy D, Buchan I, Woodcock A, Simpson A, Custovic A. Body mass index in young children and allergic disease: gender differences in a longitudinal study. Clin Exp Allergy. 2011;41:78–85.CrossRefPubMedGoogle Scholar
  34. 34.
    Yao TC, Ou LS, Yeh KW, Lee WI, Chen LC, Huang JL. Associations of age, gender, and BMI with prevalence of allergic diseases in children: PATCH study. J Asthma. 2011;48:503–10.CrossRefPubMedGoogle Scholar
  35. 35.
    Mitchell EA, Beasley R, Bjorksten B, Crane J, Garcia-Marcos L, Keil U. The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC phase three. Clin Exp Allergy. 2013;43:73–84.CrossRefPubMedGoogle Scholar
  36. 36.
    Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. Curr Probl Dermatol. 2011;41:1–34.CrossRefPubMedGoogle Scholar
  37. 37.
    von Mutius E. Maternal farm exposure/ingestion of unpasteurized cow’s milk and allergic disease. Curr Opin Gastroenterol. 2012;28:570–6.CrossRefGoogle Scholar
  38. 38.
    Langan SM, Flohr C, Williams HC. The role of furry pets in eczema: a systematic review. Arch Dermatol. 2007;143:1570–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Dom S, Droste JH, Sariachvili MA, Hagendorens MM, Oostveen E, Bridts CH, Stevens WJ, Wieringa MH, Weyler JJ. Pre- and post-natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years. Clin Exp Allergy. 2010;40:1378–87.CrossRefPubMedGoogle Scholar
  40. 40.
    Tsakok T, McKeever TM, Yeo L, Flohr C. Does early life exposure to antibiotics increase the risk of eczema? A systematic review. Br J Dermatol. 2013;169:983–91.CrossRefPubMedGoogle Scholar
  41. 41.
    Wang M, Karlsson C, Olsson C, Adlerberth I, Wold AE, Strachan DP, Martricardi PM, Aberg N, Perkin MR, Tripodi S, Coates AR, Hesselmar B, Saalman R, Molin G, Ahrne S. Reduced diversity in the early fecal microbiota of infants with atopic eczema. J Allergy Clin Immunol. 2008;121:129–34.CrossRefPubMedGoogle Scholar
  42. 42.
    Emerson RM, Williams HC, Allen BR. What is the cost of atopic dermatitis in preschool children? Br J Dermatol. 2001;144:514–22.CrossRefPubMedGoogle Scholar
  43. 43.
    Herd RM, Tidman MJ, Prescott RJ, Hunter JAA. The cost of atopic eczema. Br J Dermatol. 1996;135:20–3.CrossRefPubMedGoogle Scholar
  44. 44.
    Mancini AJ, Kaulback K, Chamlin SL. The socioeconomic impact of atopic dermatitis in the United States: a systematic review. Pediatr Dermatol. 2008;25:1–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Kim C, Park KY, Ahn S, Kim DH, Li K, Kim DW, Kim M, Jo S, Yim HW, Seo SJ. Economic impact of atopic dermatitis in Korean patients. Ann Dermatol. 2015;27(3):298–305.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Lapidus CS, Schwarz DF, Honig PJ. Atopic dermatitis in children: who cares? Who pays? J Am Acad Dermatol. 1993;29:699–703.CrossRefGoogle Scholar
  47. 47.
    Hay RJ, Johns NE, Williams HC, Bollinger IW, Dellavalle RP, Margolis DJ, Marks R, Naldi L, Weinstock MA, Wulf SK, Michaud C, Murray CJ, Maghavi M. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Investig Dermatol Symp Proc. 2014;134:1527–34.CrossRefGoogle Scholar
  48. 48.
    Senra MS, Wollenberg A. Psychodermatological aspects of atopic dermatitis. Br J Dermatol. 2014;170:38–43.CrossRefPubMedGoogle Scholar
  49. 49.
    Chang YS, Chou YT, Lee JH, Lee PL, Yang-Shia D, Sun C, Lin YT, Wang LC, Yu H, Yang YH, Chen CA, Wan KS, Chiang BL. Atopic dermatitis, melatonin, and sleep disturbance. Pediatrics. 2014;134:e397–405.CrossRefPubMedGoogle Scholar
  50. 50.
    Arndt J, Smith N, Tausk F. Stress and atopic dermatitis. Curr Allergy Asthma Rep. 2008;8:312–7.CrossRefPubMedGoogle Scholar
  51. 51.
    Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112:S118–27.CrossRefPubMedGoogle Scholar
  52. 52.
    Bender BG, Leung SB, Leung DY. Actigraphy assessment of sleep disturbance in patients with atopic dermatitis: an objective life quality measure. J Allergy Clin Immunol. 2003;111:598–602.CrossRefPubMedGoogle Scholar
  53. 53.
    Hon KL, Lam MC, Wong KY, Leung TF, Ng PC. Pathophysiology of nocturnal scratching in childhood atopic dermatitis: the role of brain-derived neurotrophic factor and substance P. Br J Dermatol. 2007;157:922–5.CrossRefPubMedGoogle Scholar
  54. 54.
    Oh SH, Bae BG, Park CO, Noh JY, Park IH, Wu WH, Lee KH. Association of stress with symptoms of atopic dermatitis. Acta Derm Venereol. 2010;90:582–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Denda M, Takei K, Denda S. How does epidermal pathology interact with mental state? Med Hypotheses. 2013;80:194–6.CrossRefPubMedGoogle Scholar
  56. 56.
    Miller AH, Haroon E, Raison CL, Felger JC. Cytokine targets in the brain: impact on neurotransmitters and neurocircuits. Depress Anxiety. 2013;30:297–306.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Yarlagadda A, Alfson E, Clayton AH. The blood brain barrier and the role of cytokines in neuropsychiatry. Psychiatry. 2009;6:18–22.PubMedPubMedCentralGoogle Scholar
  58. 58.
    Salek MS, Jung S, Brincat-Ruffini LA, MacFarlane L, Lewis-Jones MS, Basra MK, Finlay AY. Clinical experience and psychometric properties of the Children’s dermatology life quality index (CDLQI), 1995–2012. Br J Dermatol. 2013;169:734–59.CrossRefPubMedGoogle Scholar
  59. 59.
    Brenninkmeijer EE, Legierse CM, Sillevis Smitt JH, Last BF, Grootenhuis MA, Bos JD. The course of life of patients with childhood atopic dermatitis. Pediatr Dermatol. 2009;26:14–22.CrossRefPubMedGoogle Scholar
  60. 60.
    LeBovidge JS, Elverson W, Timmons KG, Hawryluk EB, Rea C, Lee M, Schneider LC. Multidisciplinary interventions in the management of atopic dermatitis. J Allergy Clin Immunol. 2016;138:325–34.CrossRefPubMedGoogle Scholar
  61. 61.
    Levy ML. Atopic dermatitis: understanding the disease and its management. Curr Med Res Opin. 2007;23(12):3091–103.CrossRefPubMedGoogle Scholar
  62. 62.
    Gelbard CM, Hebert AA. New and emerging trends in the treatment of atopic dermatitis. Patient Pref Adherence. 2008;2:387–92.Google Scholar
  63. 63.
    Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109–22.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of DermatologyWake Forest University School of MedicineWinston SalemUSA
  2. 2.Department of DermatologyHoward University School of MedicineWashington, DCUSA

Personalised recommendations