Clinical differences between atopic and atopiform dermatitis - 24/04/13
, Phyllis I. Spuls, MD, PhD a, b, Catharina M. Legierse, MD a, Robert Lindeboom, PhD c, J. Henk Sillevis Smitt, MD, PhD a, Jan D. Bos, MD, PhD, FRCP a, ⁎ 
Reprint requests: Jan D. Bos, MD, PhD, FRCP, Department of Dermatology, Academic Medical Center, University of Amsterdam, The Netherlands.Correspondence to: Elian E. A. Brenninkmeijer, MD, Department of Dermatology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.Abstract |
Background |
Atopic dermatitis (AD) has been divided into the “extrinsic” and “intrinsic” type, in which “intrinsic AD” is characterized by the absence of allergen-specific IgE. Still, there is no consensus whether this “intrinsic type” of AD, which we denominate as atopiform dermatitis (AFD), is a distinct entity.
Objective |
A case-control study was performed to compare the clinical and diagnostic features of AD and AFD.
Methods |
Patients with a clinical diagnosis of AD were selected. Cases did not have demonstrable allergen-specific IgE. Matched control subjects were tested positive for allergen-specific IgE. Patients were evaluated for medical history, quality of life, disease severity, and Hanifin and Rajka, U.K. and Millennium diagnostic criteria.
Results |
Eight percent (n = 34) of the selected patients had, in fact, AFD. Female predominance, absence of atopic diseases, later onset of disease, and milder disease severity were observed in AFD. A history of atopy, recurrent conjunctivitis, palmar hyperlinearity, keratosis pilaris, pityriasis alba, and hand and/or food eczema were significantly less present in AFD. Dennie-Morgan fold was positively associated with AFD.
Limitations |
Not all patients with negative allergen-specific IgE participated and a relatively small number of AFD patients were studied.
Conclusions |
In addition to the absence of allergen-specific IgE, our findings support that AFD is an entity distinct from AD. With a distinction shown between AFD and AD, patient groups will be better defined and more homogeneous. Implications of this distinction will be of importance for preventive and therapeutic advice; diagnostic processes; and for future research.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations used : AD, AFD, AMC, EASI, IGA, IQR, QoL, SCORAD, SPT
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 58 - N° 3
P. 407-414 - marzo 2008 Ritorno al numero
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