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Hauterkrankung im Kindesalter

Schweres atopisches Ekzem oder primärer Immundefekt?

Atopic eczema in childhood or primary immunodeficiency — what needs to be considered?

  • FORTBILDUNG . ÜBERSICHT
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MMW - Fortschritte der Medizin Aims and scope

Trockene, rote, juckende Haut im Säuglings- und Kleinkindalter ist ein häufiger Vorstellungsgrund für Eltern beim Allgemein-, Kinder- oder Hautarzt. Meist äußern Eltern hierbei bereits die Sorge, dass bei ihrem Kind ein atopisches Ekzem (auch Neurodermitis oder atopische Dermatitis genannt) bestehen könnte. Viel brisanter ist jedoch die Frage, ob der kleine Patient einen primären Immundefekt hat.

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Literatur

  1. Werfel T et al. S2k guideline on diagnosis and treatment of atopic dermatitis—short version. J Dtsch Dermatol Ges. 2016;14:92–106

    PubMed  Google Scholar 

  2. Palmer CN et al. 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

    Article  CAS  PubMed  Google Scholar 

  3. Weidinger S et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol. 2006;118:214–9

    Article  CAS  PubMed  Google Scholar 

  4. Wollenberg A et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol. 2016;30:729–47

    Article  CAS  PubMed  Google Scholar 

  5. Horimukai K et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. 2014;134:824–30 e6

    Article  PubMed  Google Scholar 

  6. Simpson EL et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014;134:818–23

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ring J et al. Guidelines for treatment of atopic eczema (atopic dermatitis) part I. J Eur Acad Dermatol Venereol. 2012;26:1045–60

    Article  CAS  PubMed  Google Scholar 

  8. Wollenberg A et al. Proactive therapy of atopic eczema — an evidence-based concept with a behavioral background. J Dtsch Dermatol Ges. 2009;7:17–21

    Google Scholar 

  9. Wollenberg A, Ehmann LM. Long term treatment concepts and proactive therapy for atopic eczema. Ann Dermatol. 2012;24:253–60

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Thaci D et al. Proactive disease management with 0.03% tacrolimus ointment for children with atopic dermatitis: results of a randomized, multicentre, comparative study. Br J Dermatol. 2008;159:1348–56

    Article  CAS  PubMed  Google Scholar 

  11. Wollenberg A et al. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy. 2008;63:742–50

    Article  CAS  Google Scholar 

  12. Arkwright PD et al. Management of difficult-to-treat atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1:142–51

    Article  PubMed  Google Scholar 

  13. Ring J et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. J Eur Acad Dermatol Venereol. 2012;26:1176–93

    Article  CAS  PubMed  Google Scholar 

  14. Simpson EL et al. Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis. N Engl J Med. 2016;375:2335–48

    Article  CAS  PubMed  Google Scholar 

  15. Ruzicka T et al. Anti-Interleukin-31 Receptor A Antibody for Atopic Dermatitis. N Engl J Med. 2017 [in press]

  16. Staab D et al. Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. BMJ. 2006;332:933–8

    Article  PubMed  PubMed Central  Google Scholar 

  17. Heratizadeh A, Werfel T, Gieler U. AGNES und ARNE — Konzept der Neurodermitisschulung für Erwachsene. Prävention Rehabil. 2011;23:41–2

    Google Scholar 

  18. Ochs HD, Smith CIE, Puck JM. Primary Immunodeficiency Diseases — A Molucular And Genetic Approach. 2nd ed. 2007, New York, NY: Oxford University Press.

    Google Scholar 

  19. Stiehm ER, Ochs HD, Winkelstein JA. Immunologic Disorders in Infants&Childrens. 2004, Elsevier Saunders: Philadelphia, Pennsylvania.

    Google Scholar 

  20. Hagl B et al. Key findings to expedite the diagnosis of hyper-IgE syndromes in infants and young children. Pediatr Allergy Immunol. 2016;27:177–84

    Article  PubMed  Google Scholar 

  21. Boos AC et al. Atopic dermatitis, STAT3- and DOCK8-hyper-IgE syndromes differ in IgE-based sensitization pattern. Allergy. 2014;69:943–53

    Article  CAS  PubMed  Google Scholar 

  22. Renner ED et al. Comel-Netherton syndrome defined as primary immunodeficiency. J Allergy Clin Immunol. 2009;124:536–43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Thrasher AJ. WASp in immune-system organization and function. Nat Rev Immunol. 2002;2:635–46

    Article  CAS  PubMed  Google Scholar 

  24. Gambineri E, Torgerson TR, Ochs HD. Immune dysregulation, polyendocrinopathy, enteropathy, and X-linked inheritance (IPEX), a syndrome of systemic autoimmunity caused by mutations of FOXP3, a critical regulator of T-cell homeostasis. Curr Opin Rheumatol. 2003;15:430–5

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Neurodermitis-Spezialambulanz, Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstrasse 9–11, D-80337, München, Deutschland

    Andreas Wollenberg

  2. Immunambulanz, Umweltmedizin, UNIKA-T, Helmholtz-Zentrum München, Klinikum rechts der Isar, TU München, München, Deutschland

    Ellen Renner &  Beate Hagl

  3. Umweltmedizin, UNIKA-T, Immunambulanz, Neusässer Straße 47, D-86156, Augsburg, Deutschland

    Ellen Renner

Authors
  1. Andreas Wollenberg
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  2. Ellen Renner
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  3. Beate Hagl
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Corresponding author

Correspondence to Andreas Wollenberg.

Additional information

Danksagung: Wir danken unseren Patientenfamilien und den zuweisenden Kollegen für das gegenseitige Vertrauen und Herrn Prof. Dr. med. Dr. h.c. mult. Thomas Ruzicka, Frau Prof. Dr. med. Claudia Traidl-Hoffmann, Herrn Prof. Dr. med. Tilo Biedermann und Herrn Prof. Dr. Dr. Christoph Klein für ihre Unterstützung.

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Wollenberg, A., Renner, E. & Hagl, B. Schweres atopisches Ekzem oder primärer Immundefekt?. MMW - Fortschritte der Medizin 159, 59–63 (2017). https://doi.org/10.1007/s15006-017-0330-y

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  • DOI: https://doi.org/10.1007/s15006-017-0330-y

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