Senile Atopic Dermatitis

Abstract

Atopic dermatitis (AD) in the elderly represents a newly defined subgroup of AD. Elderly patients with AD show some characteristic clinical manifestations. Skin manifestations of elderly AD basically match those of adolescent/adult AD, but a lack of involvement of the folds of the elbows and knees is more common than the classic sign of localized lichenification in those folds. Elderly patients with immunoglobulin (Ig)E-allergic AD show high rates of positivity for specific IgE antibodies against house dust mites. In immunohistopathology, IgE-mediated allergic inflammation with IgE+ mast cells and IgE+ dendritic cells (i.e., Langerhans cells and inflammatory dendritic cells) in association with environmental allergens (e.g., house dust mites) may exist in the lichenified eczema of IgE-allergic elderly AD. The prevalence of elderly AD, which shows a tendency toward a male predominance, is approximately 1–3% among elderly populations in industrialized countries. In clinical practice, most elderly patients with AD obtain amelioration of skin manifestations once suitable management is implemented, but most elderly patients with AD still reach the end of life with AD. AD should now be considered as a lifelong allergic condition in some populations.