Dermatology in India
Features Of Atopic Dermatitis In Adults
Atopic dermatitis in older patients: particular points.
Katsarou A, Armenaka MC.
J Eur Acad Dermatol Venereol. 2010 Jun 21.
Atopic Dermatitis (AD) is increasing in its frequency mostly due to the phenomenal increase in atopy we have seen in the last 20 years. Therefore more and more adults are presenting at the consultation and it is important to know that differences exist. The following article highlights some of the differences. In adults:
-5-15% of cases are intrinsic (endogenous) and are therefore non IgE (non allergic).
-Food allergy does not play an important but reactions interpreted by the patient as allergic (but non-IgE-mediated) can give rise to eczematous lesions.
-HDM (House-dust mite) allergy is present in the majority (IgE tests/atopy patch test.
-Allergic contact dermatitis and irritant contact dermatitis is increased. This is an issue in adolescence when choosing a job.
-Most interestingly although children and adults with AD are colonized with Staphylococcus Aureus adult skin is more heavily colonized with Malassezia yeasts. Sensitivity reactions occur especially in head eczema. Although not studied yet, anti-yeast topical treatment could bring interesting clinical results and should be analyzed in further studies.
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