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Atopisches Ekzem im Erwachsenenalter

Atopic exzema in adulthood

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Zusammenfassung

Die Prävalenz des atopischen Ekzems (AE) im Erwachsenenalter beträgt 1–3%. Positive Familienanamnese, früher Erkrankungsbeginn, schwerer Krankheitsverlauf im Kindesalter und Komorbidität mit anderen Erkrankungen des atopischen Formenkreises sind Prädiktoren für die Persistenz des AE bis ins Erwachsenenalter, außerdem wird von genetischen Risikofaktoren ausgegangen. Auch eine Erstmanifestation des AE im Erwachsenenalter ist möglich. Stress und psychische Belastung wurden unabhängig vom Geschlecht als wichtigster Schubfaktor des AE eingestuft. Bisher steht keine kausale Therapie für das AE zur Verfügung. Die Basis der symptomatischen Therapie besteht aus einer stadiengerechten pflegenden und rückfettenden Lokaltherapie, antiseptischen Externa und Antipruriginosa. Bei Exazerbation kommen topische Kortikosteroide und/oder topische Calcineurininhibitoren zum Einsatz. Für erwachsene Patienten mit schwerem AE, die mit den zur Verfügung stehenden topischen Therapieoptionen nicht ausreichend effektiv behandelt werden können, werden neben Antihistaminika und ggf. Antibiotika eine UV-Therapie und immunsuppressive bzw. immunmodulatorische Systemtherapeutika empfohlen.

Abstract

The prevalence of atopic eczema (AE) in adulthood is 1–3%. A positive family history, early disease onset, a severe disease course in childhood, and comorbidity of other disorders among the circle of atopic forms are predictors for persistence of AE into adulthood; furthermore, genetic risk factors are assumed. Initial manifestation of AE in adulthood is also possible. Stress/psychological burden have been classified as the most important triggering factor of AE. To date a causal therapy for AE is not available. The basis of symptomatic treatment consists of stage-appropriate skin care and moisturizing local therapy, antiseptic agents for external application, and antipruritic agents. In cases of exacerbation topical corticosteroids and/or topical calcineurine inhibitors are used. For the adult patient with severe AE who cannot be treated effectively with the topical treatment options available, UV therapy and immunosuppressive or immunomodulatory systemic drugs are recommended.

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  1. Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    J. Schmitt, A. Bauer &  M. Meurer

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Schmitt, J., Bauer, A. & Meurer, M. Atopisches Ekzem im Erwachsenenalter. Hautarzt 59, 841–852 (2008). https://doi.org/10.1007/s00105-008-1503-5

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