Immune mechanisms in atopic dermatitis.

Abstract

Atopic dermatitis (A. D.) is a chronic inflammatory skin disease that frequently occurs in patients with a personal or family history of other allergic disorders such as allergic rhinitis or asthma. A. D. is a very common disease, with an incidence of 4 % in children under seven years of age [32, 94] and of 7.0 % in individuals of all ages [68]. The clinical features and natural course of A. D. are highly variable and have been reviewed by numerous investigators [3,55,71,78]. The major diagnostic features of A. D. include pruritus, a distinctive clinical morphology and distribution pattern, and a chronic or chronically relapsing course of dermatitis [34]. During infancy the rash is typically more eczematous, involving the face and extensor areas, whereas the adolescent and adult phase is characterized by thickening and lichenification with involvement of the flexural areas and the neck. Seventy percent of patients with atopic dermatitis have a family history of atopy, and an elevated serum IgE level and 50 % of older patients give a personal history of allergic respiratory disease.