Atopic dermatitis classification: Difference between revisions

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==Overview==
==Overview==
There is no established system for the classification of atopic dermatitis. It may be classified into Intrinsic atopic dermatitis and extrinsic atopic dermatitis according to means of allergic sensitization. Intrinsic atopic dermatitis is associated with normal serum IgE levels vs elevated total serum IgE levels.
There is no established system for the classification of atopic dermatitis. It may be classified into intrinsic atopic dermatitis and extrinsic atopic dermatitis according to means of allergic [[sensitization]]. Intrinsic atopic dermatitis is associated with normal serum [[IgE]] levels vs elevated total serum [[IgE]] levels.


==Classification==
==Classification==


There is no established system for the classification of atopic dermatitis.
There is no established system for the [[classification]] of atopic dermatitis.


Atopic dermatitis may be classified according to means of allergic sensitization into:<ref name="pmid12897728">{{cite journal |vauthors=Novak N, Bieber T |title=Allergic and nonallergic forms of atopic diseases |journal=J. Allergy Clin. Immunol. |volume=112 |issue=2 |pages=252–62 |date=August 2003 |pmid=12897728 |doi= |url=}}</ref>
Atopic dermatitis may be classified according to means of allergic [[sensitization]] into:<ref name="pmid12897728">{{cite journal |vauthors=Novak N, Bieber T |title=Allergic and nonallergic forms of atopic diseases |journal=J. Allergy Clin. Immunol. |volume=112 |issue=2 |pages=252–62 |date=August 2003 |pmid=12897728 |doi= |url=}}</ref>
* Intrinsic atopic dermatitis
* Intrinsic atopic dermatitis
* Extrinsic atopic dermatitis
* Extrinsic atopic dermatitis
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* Normal serum IgE levels<ref name="pmid16965428">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
* Normal serum [[IgE]] levels<ref name="pmid16965428">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>


* No specific IgE sensitization against<ref name="pmid12861844">{{cite journal |vauthors=Wüthrich B, Schmid-Grendelmeier P |title=The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS |journal=J Investig Allergol Clin Immunol |volume=13 |issue=1 |pages=1–5 |date=2003 |pmid=12861844 |doi= |url=}}</ref>  
* No specific IgE sensitization against<ref name="pmid12861844">{{cite journal |vauthors=Wüthrich B, Schmid-Grendelmeier P |title=The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS |journal=J Investig Allergol Clin Immunol |volume=13 |issue=1 |pages=1–5 |date=2003 |pmid=12861844 |doi= |url=}}</ref>  
** Environmental allergens
** Environmental [[allergens]]
** Food allergens
** [[Food allergens]]
** Skin prick tests
** Skin prick tests


* No filaggrin mutation
* No [[filaggrin]] [[mutation]]
* Relative lower levels of IL-4 and IL-13<ref name="pmid23777851">{{cite journal |vauthors=Suárez-Fariñas M, Dhingra N, Gittler J, Shemer A, Cardinale I, de Guzman Strong C, Krueger JG, Guttman-Yassky E |title=Intrinsic atopic dermatitis shows similar TH2 and higher TH17 immune activation compared with extrinsic atopic dermatitis |journal=J. Allergy Clin. Immunol. |volume=132 |issue=2 |pages=361–70 |date=August 2013 |pmid=23777851 |pmc=3991240 |doi=10.1016/j.jaci.2013.04.046 |url=}}</ref>
* Relative lower levels of [[Interleukin 4|IL-4]] and [[Interleukin 13|IL-13]]<ref name="pmid23777851">{{cite journal |vauthors=Suárez-Fariñas M, Dhingra N, Gittler J, Shemer A, Cardinale I, de Guzman Strong C, Krueger JG, Guttman-Yassky E |title=Intrinsic atopic dermatitis shows similar TH2 and higher TH17 immune activation compared with extrinsic atopic dermatitis |journal=J. Allergy Clin. Immunol. |volume=132 |issue=2 |pages=361–70 |date=August 2013 |pmid=23777851 |pmc=3991240 |doi=10.1016/j.jaci.2013.04.046 |url=}}</ref>
* Increased eosinophil counts and eosinophil cationic protein levels<ref name="pmid169654283">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
* Increased [[eosinophil]] counts and [[eosinophil cationic protein]] levels<ref name="pmid169654283">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
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* Elevated total serum IgE levels<ref name="pmid169654282">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
* Elevated total serum [[IgE]] levels<ref name="pmid169654282">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>


* IgE sensitization against<ref name="pmid128618442">{{cite journal |vauthors=Wüthrich B, Schmid-Grendelmeier P |title=The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS |journal=J Investig Allergol Clin Immunol |volume=13 |issue=1 |pages=1–5 |date=2003 |pmid=12861844 |doi= |url=}}</ref>
* IgE [[sensitization]] against<ref name="pmid128618442">{{cite journal |vauthors=Wüthrich B, Schmid-Grendelmeier P |title=The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS |journal=J Investig Allergol Clin Immunol |volume=13 |issue=1 |pages=1–5 |date=2003 |pmid=12861844 |doi= |url=}}</ref>
** Environmental allergens
** Environmental [[allergens]]
** Food allergens
** [[Food allergens]]
** Skin prick tests
** Skin prick tests


* Filaggrin mutations may be present<ref name="pmid17096018">{{cite journal |vauthors=Weidinger S, Rodríguez E, Stahl C, Wagenpfeil S, Klopp N, Illig T, Novak N |title=Filaggrin mutations strongly predispose to early-onset and extrinsic atopic dermatitis |journal=J. Invest. Dermatol. |volume=127 |issue=3 |pages=724–6 |date=March 2007 |pmid=17096018 |doi=10.1038/sj.jid.5700630 |url=}}</ref>
* [[Filaggrin]] [[Mutation|mutations]] may be present<ref name="pmid17096018">{{cite journal |vauthors=Weidinger S, Rodríguez E, Stahl C, Wagenpfeil S, Klopp N, Illig T, Novak N |title=Filaggrin mutations strongly predispose to early-onset and extrinsic atopic dermatitis |journal=J. Invest. Dermatol. |volume=127 |issue=3 |pages=724–6 |date=March 2007 |pmid=17096018 |doi=10.1038/sj.jid.5700630 |url=}}</ref>
* Increased levels of IL-4, IL-5 and IL-13
* Increased levels of [[Interleukin 4|IL-4]], [[Interleukin 5|IL-5]] and [[Interleukin 13|IL-13]]
* Increased eosinophil counts and eosinophil cationic protein levels<ref name="pmid169654284">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
* Increased [[eosinophil]] counts and [[eosinophil cationic protein]] levels<ref name="pmid169654284">{{cite journal |vauthors=Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM |title=Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables |journal=Br. J. Dermatol. |volume=155 |issue=4 |pages=778–83 |date=October 2006 |pmid=16965428 |doi=10.1111/j.1365-2133.2006.07394.x |url=}}</ref>
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Revision as of 16:03, 18 October 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There is no established system for the classification of atopic dermatitis. It may be classified into intrinsic atopic dermatitis and extrinsic atopic dermatitis according to means of allergic sensitization. Intrinsic atopic dermatitis is associated with normal serum IgE levels vs elevated total serum IgE levels.

Classification

There is no established system for the classification of atopic dermatitis.

Atopic dermatitis may be classified according to means of allergic sensitization into:[1]

  • Intrinsic atopic dermatitis
  • Extrinsic atopic dermatitis
Intrinsic atopic dermatitis Extrinsic atopic dermatitis
  • Elevated total serum IgE levels[6]

References

  1. ↑ Novak N, Bieber T (August 2003). "Allergic and nonallergic forms of atopic diseases". J. Allergy Clin. Immunol. 112 (2): 252–62. PMID 12897728.
  2. ↑ Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM (October 2006). "Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables". Br. J. Dermatol. 155 (4): 778–83. doi:10.1111/j.1365-2133.2006.07394.x. PMID 16965428.
  3. ↑ Wüthrich B, Schmid-Grendelmeier P (2003). "The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS". J Investig Allergol Clin Immunol. 13 (1): 1–5. PMID 12861844.
  4. ↑ Suárez-Fariñas M, Dhingra N, Gittler J, Shemer A, Cardinale I, de Guzman Strong C, Krueger JG, Guttman-Yassky E (August 2013). "Intrinsic atopic dermatitis shows similar TH2 and higher TH17 immune activation compared with extrinsic atopic dermatitis". J. Allergy Clin. Immunol. 132 (2): 361–70. doi:10.1016/j.jaci.2013.04.046. PMC 3991240. PMID 23777851.
  5. ↑ Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM (October 2006). "Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables". Br. J. Dermatol. 155 (4): 778–83. doi:10.1111/j.1365-2133.2006.07394.x. PMID 16965428.
  6. ↑ Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM (October 2006). "Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables". Br. J. Dermatol. 155 (4): 778–83. doi:10.1111/j.1365-2133.2006.07394.x. PMID 16965428.
  7. ↑ Wüthrich B, Schmid-Grendelmeier P (2003). "The atopic eczema/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated ("extrinsic") and the nonallergic ("intrinsic") AEDS". J Investig Allergol Clin Immunol. 13 (1): 1–5. PMID 12861844.
  8. ↑ Weidinger S, Rodríguez E, Stahl C, Wagenpfeil S, Klopp N, Illig T, Novak N (March 2007). "Filaggrin mutations strongly predispose to early-onset and extrinsic atopic dermatitis". J. Invest. Dermatol. 127 (3): 724–6. doi:10.1038/sj.jid.5700630. PMID 17096018.
  9. ↑ Park JH, Choi YL, Namkung JH, Kim WS, Lee JH, Park HJ, Lee ES, Yang JM (October 2006). "Characteristics of extrinsic vs. intrinsic atopic dermatitis in infancy: correlations with laboratory variables". Br. J. Dermatol. 155 (4): 778–83. doi:10.1111/j.1365-2133.2006.07394.x. PMID 16965428.

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