Pathogenetical features of atopic dermatitis in adults

Abstract

Objective – to compare pathogenesis features of atopic dermatitis in adult patients with early and late onset of the disease.Materials and methods. 123 adults with atopic dermatitis (AD) with early and late onset of the disease were examined. Clinical and diagnostically important features were compared, clinical effectiveness of the treatment, secretion of serum total IgE, IFN-γ, and IL-4 in AD course were studied.Results and discussion. Lower incidence of typical clinical course and evident allergic personal or family history was determined for AD patients with late disease onset in comparison to patients with early disease start. Two different from pathogenesis point of view variants of AD were determined for both early and late AD onset patients: one with high total serum IgE and relation between IL-4 and the disease severity, the other with normal total serum IgE level and dependence of the disease severity on IFN-γ secretion. Due to cross-over increase of IFN-γ synthesis and decrease of IL-4 synthesis in patients with IgE-dependent variant of AD, the common duration of in-patient treatment phase is longer for such patients. Early out-patient follow-up of such patients requires continuation of systemic treatment.Conclusions. Atopic dermatitis in adults with early and late age of onset has some distinctive clinical and pathogenesis features and two different variants of the course. IgE-dependent variant of AD is connected with longer duration of in-patient management and necessity to continue the systemic treatment during follow-up.