Información del artículo
Abstract
Although childhood atopic dermatitis is reported throughout the world, it has become a health priority in developed countries, where its prevalence is particularly high. Despite extensive study for many years, various aspects of the disease are still subject to debate. This review will discuss the main studies published on the topic and update certain concepts such as the terminology used (the difference between atopic and atopiform), epidemiology, etiopathogenesis (molecular mechanisms, implicated genes, and environmental factors), assessment of severity, influence on the quality of life of the patients and their families, economic impact, and treatment.
Key words:
atopic dermatitis
epidemiology
quality of life
costs
costs analysis
Resumen
La dermatitis atópica infantil es una enfermedad de distribución mundial, con una elevada prevalencia en los países desarrollados, lo que la ha convertido en una prioridad de salud. A pesar de que es una entidad que ha sido estudiada durante años todavía existen numerosas controversias en distintas áreas. En esta revisión se comentan los principales trabajos publicados sobre el tema, actualizando diversos conceptos: terminología aplicada (diferencia entre atópica y atopiforme), epidemiología, etiopatogenia (estudios moleculares, genes implicados y factores ambientales), medida de la gravedad, influencia en la calidad de vida del paciente y la familia, impacto económico y tratamientos.
Palabras clave:
dermatitis atópica
epidemiología
calidad de vida
costos y análisis de costo
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References
[1.]
E.L. Simpson, J.M. Hanifin.
Atopic dermatitis.
Med Clin N Am, 90 (2006), pp. 149-167
[2.]
F. Wise, M.B. Sulzberger.
Editorial remarks.
Year book of dermatology and syphilogy, Year book Medical Publisher, (1933),
[3.]
D.J. Eedy, R.A. Graham-Brown.
Atopiform dermatitis: what's in a name?.
Br J Dermatol, 147 (2002), pp. 415-417
[5.]
J.M. Hanifin.
Atopiform dermatitis: Do we need another confusing name for atopic dermatitis?.
Br J Dermatol, 147 (2002), pp. 430-432
[6.]
A.F. Coco, R.A. Cooke.
On the classification of the phenomenon of hypersensitivities.
J Immunol, 8 (1923), pp. 163-182
[7.]
S.G. Johansson, T. Bieber, R. Dahl, P.S. Friedmann, B.Q. Lanier, R.F. Lockey, et al.
Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003.
J Allergy Clin Immunol, 113 (2004), pp. 832-836
[8.]
D.Y. Leung, T. Bieber.
Atopic dermatitis.
Lancet, 361 (2003), pp. 151-160
[9.]
W. Abramovits.
Atopic dermatitis.
J Am Acad Dermatol, 53 (2005), pp. s86-s93
[10.]
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee.
Worldwide variation in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC.
Lancet, 351 (1998), pp. 1225-1232
[11.]
A.B. Olesen, K. Bang, S. Juul, K. Thestrup-Pedersen.
Stable incidence of atopic dermatitis among children in Denmark during the 1990s.
Acta Derm Venereol, 85 (2005), pp. 244-247
[12.]
A. Yura, T. Shimizu.
Trends in the prevalence of atopic dermatitis in school children: longitudinal study in Osaka Prefecture, Japan, from 1985 to 1997.
Br J Dermatol, 145 (2001), pp. 966-973
[13.]
L. Grize, M. Gassner, B. Wuthrich, B. Bringolf-Isler, K. Takken-Sahli, F.H. Sennhauser, Swiss Surveillance Programme on Childhood Allergy and Respiratory symptoms with respect to Air Pollution (SCARPOL) team, et al.
Trends in the prevalence of asthma, allergic rhinitis and atopic dermatitis in 5-7 year old Swiss children from 1991 to 2001.
Allergy, 61 (2006), pp. 556-562
[14.]
B. Taylor, J. Wadsworth, M. Wadsworth, C. Peckham.
Changes in the reported prevalence of childhood eczema since the 1939-45 war.
Lancet, 2 (1984), pp. 1255-1257
[15.]
C.G. Mortz, J.M. Lauritsen, C. Bindslev-Jensen, K.E. Andersen.
Prevalence of atopic dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis.
Br J Dermatol, 144 (2001), pp. 523-532
[16.]
M. Möhrenschlager, T. Schäfer, J. Huss-Marp, B. Eberlein-König, S. Weidinger, J. Ring, et al.
The course of eczema in children aged 5-7 years and its relation to atopy: differences between boys and girls.
Br J Dermatol, 154 (2006), pp. 505-513
[17.]
C.A. Akdis, M. Akdis, T. Biber, C. Bindslev-Jensen, M. Boquniewicz, P. Eigenmann, et al.
European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL. Consensus Report.
J Allergy Clin Immunol, 118 (2006), pp. 152-169
[18.]
H.C. Williams.
Atopic dermatitis.
N Engl J Med, 352 (2005), pp. 2314-2324
[19.]
H.C. Williams, C. Flohr.
How epidemiology has challenged 3 prevailing concepts about atopic dermatitis.
J Allergy Clin Immunol, 118 (2006), pp. 209-213
[20.]
S. Illi, E. Von Mutius, S. Lau, R. Nickel, C. Gruber, B. Niggemann, Multicenter Allergy Study Group, et al.
The natural course of atopic dermatitis from birth to age 7 years and the association with asthma.
J Allergy Clin Immunol, 113 (2004), pp. 925-931
[21.]
L.F. Eichenfield, J.M. Hanifin, T.A. Luger, S.R. Stevens, H.B. Pride.
Consensus conference on pediatric atopic dermatitis.
J Am Acad Dermatol, 49 (2003), pp. 1088-1095
[22.]
B. Homey, M. Steinhoff, T. Ruzicka, D.Y.M. Leung.
Cytokines and chemokines orchestrate atopic skin inflammation.
J Allergy Clin Immunol, 118 (2006), pp. 178-189
[23.]
I. Angelova-Fischer, U.C. Hipler, A. Bauer, J.W. Fluhr, N. Tsankov, T.W. Fischer, et al.
Significance of interleukin-16, macrophage-derived chemokine, eosinophil cationic protein and soluble E-selectin in reflecting disease activity of atopic dermatitis -from laboratory parameters to clinical scores.
Br J Dermatol, 154 (2006), pp. 1112-1117
[24.]
Nagel G, Koenig W, Rapp K, Wabitsch M, Zoellner I, Weiland SK. Associations of adipokines with asthma, rhinoconjunctivitis and eczema in German schoolchildren. Pediatr Allergy Immunol. 2008 (in press). Available as Epublication ahead of print: DOI: 10.1111/j.1399-3038.2008.00740.
[25.]
C.J. Van Asch, W.A. Balemans, M.M. Rovers, A.G. Schilder, C.K. Van der Ent.
Atopic disease and exhaled nitric oxide in an unselected population of young adults.
Ann Allergy Asthma Immunol, 100 (2008), pp. 59-65
[26.]
S. Forrest, K. Dunn, K. Elliott, E. Fitzpatrick, J. Fullerton, M. McCarthy, et al.
Identifying genes predisposing to atopic eczema.
J Allergy Clin Immunol, 104 (1999), pp. 1066-1070
[27.]
A. Kato, K. Fukai, N. Oiso, N. Hosomi, T. Murakami, M. Ishii.
Association of SPINK5 gene polymorphisms with atopic dermatitis in the Japanese population.
Br J Dermatol, 148 (2003), pp. 665-669
[28.]
A.D. Irvine, W.H. McLean.
Breaking the (un)sound barrier: filaggrin is a major gene for atopic dermatitis.
J Invest Dermatol, 126 (2006), pp. 1200-1202
[29.]
A. Bowcock, W.O.C.M. Cookson.
The genetics of psoriasis, psoriatic arthritis and atopic dermatitis.
Hum Mol Genet, 13 (2004), pp. s43-s55
[30.]
S.K. Weiland, E. Von Mutius, T. Hirsch, H. Duhme, C. Fritzsch, B. Werner, et al.
Prevalence of respiratory and atopic disorders among children in the East and West of Germany five years after unification.
Eur Respir J, 14 (1999), pp. 862-870
[31.]
P.A. Eigenmann, S.H. Sicherer, T.A. Borkowski, B.A. Cohen, H.A. Sampson.
Prevalence of IgE-mediated food allergy among children with atopic dermatitis.
Pediatrics, 101 (1998), pp. e8
[32.]
G. Ricci, A. Patrizi, E. Baldi, G. Menna, M. Tabanelli, M. Masi.
Long-term follow up of atopic dermatitis: retrospective analysis of related risk factors and association with concomitant allergic diseases.
J Am Acad Dermatol, 55 (2006), pp. 765-771
[33.]
M. Gdalevich, D. Mimouni, M. David, M. Mimouni.
Breastfeeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies.
J Am Acad Dermatol, 45 (2001), pp. 520-527
[34.]
C. Flohr, D. Pascoe, H.C. Williams.
Atopic dermatitis and the “hygiene hypothesis”: too clean to be true?.
Br J Dermatol, 152 (2005), pp. 202-216
[35.]
A. Zutavern, S. Von Klot, U. Gehring, S. Krauss-Etschmann, J. Heinrich.
Pre-natal and post-natal exposure to respiratory infection and atopic diseases development: a historical cohort study.
Respir Res, 7 (2006), pp. 81
[36.]
J.C. Celedón, R.J. Wright, A.A. Litonjua, D. Sredl, L. Ryan, S.T. Weiss, et al.
Day care attendance in early life, maternal history of asthma, and asthma at the age of 6 years.
Am J Respir Crit Care Med, 167 (2003), pp. 1239-1243
[37.]
C.S. Benn, M. Melbye, J. Wolfhart, B. Bjorksten, P. Aaby.
Cohort study of sibling effect, infectious diseases, and risk of atopic dermatitis during first 18 months of life.
BMJ, 328 (2004), pp. 122-130
[38.]
L. Braback, A. Hjern, F. Rasmussen.
Trends in asthma, allergic rhinitis and eczema among Swedish conscripts from farming and non-farming enviroments. A nationwide study over three decades.
Clin Exp Allergy, 34 (2004), pp. 38-43
[39.]
W. Phipatanakul, W. Celedon, B.A. Raby, A.A. Litonjua, D.K. Milton, D. Sredl, et al.
Endotoxin exposure and eczema in the first year of life.
Pediatrics, 114 (2004), pp. 13-18
[40.]
U. Gehring, G. Bolte, W. Bischof, B. Fahlbusch, H.E. Wichmann, J. Heinrich.
Exposure to endotoxin decreases the risk of atopic eczema in infancy: a cohort study.
J Allergy Clin Immunol, 108 (2001), pp. 847-854
[42.]
I. Febrer-Bosch.
Dermatitis atópica clínica.
Dermatitis atópica, pp. 75-83
[43.]
E.A. Holm, H.C. Wulf, H. Stegmann, G.B.E. Jemec.
Life quality assessment among patients with atopic eczema.
Br J Dermatol, 154 (2006), pp. 719-725
[44.]
K.L. Hon, T.F. Leung, Y. Wong, T.F. Fok.
Lesson from performing SCORADs in children with atopic dermatitis: subjective symptoms do not correlate well with disease extent or intensity.
Int J Dermatol, 45 (2006), pp. 728-730
[45.]
C.R. Charman, A.J. Venn, H. Williams.
Measuring atopic eczema severity visually: which variables are most important to patients?.
Arch Dermatol, 141 (2005), pp. 1146-1151
[46.]
E.A. Holm, H.C. Wulf, L. Thomassen, G.B.E. Jemec.
Instrumental assessment of atopic eczema: validation of transepidermal water loss, stratum corneum hydration, erythema, scaling, and edema.
J Am Acad Dermatol, 55 (2006), pp. 772-780
[47.]
K. Moore, T.J. David, C.S. Murray, F. Child, P.D. Arkwright.
Effect of childhood eczema and asthma on parental sleep and well-being: a prospective comparative study.
Br J Dermatol, 154 (2006), pp. 514-518
[48.]
J.M. Hanifin, G. Rajka.
Diagnostic features of atopic dermatitis.
Acta Derm Venereol (Stockh), (1980), pp. 44-47
[49.]
H.C. Williams, P.G. Burney, R.J. Hay, C.B. Archer, M.J. Shipley, J.J. Hunter, et al.
The UK Working Party's Diagnostic Criteria for Atopic Dermatitis I. Derivation of a minimum set of discriminators for atopic dermatitis.
Br J Dermatol, 131 (1994), pp. 383-396
[50.]
H.C. Williams, P.G. Burney, D. Strachan, R.J. Hay.
The UK Working Party's Diagnostic Criteria for Atopic Dermatitis. II. Observer variation of clinical diagnosis and signs of atopic dermatitis.
Br J Dermatol, 131 (1994), pp. 397-405
[51.]
H.C. Williams, P.G. Burney, A.C. Pembroke, R.J. Hay.
The UK Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation.
Br J Dermatol, 131 (1994), pp. 406-416
[52.]
D. De, A.J. Kanwar, S. Handa.
Comparative efficacy of Hanifin and Rajka's criteria and the UK working party's diagnostic criteria in diagnosis of atopic dermatitis in a hospital setting in North India.
J Eur Acad Dermatol Venereol, 20 (2006), pp. 853-859
[53.]
H. Jøhnke, W. Vach, L.A. Norberg, C. Bindslev-Jensen, A. Høst, K.E. Andersen.
A comparison between criteria for diagnosing atopic eczema in infants.
Br J Dermatol, 153 (2005), pp. 352-358
[54.]
B. Ehlken, M. Mohrenschlager, B. Kugland, K. Berger, K. Quednau, J. Ring.
Cost-of-illness study in patients suffering from atopic eczema in Germany.
Hautarzt, 56 (2005), pp. 1144-1151
[55.]
R.M. Emerson, H.C. Williams, B.R. Allen.
What is the cost of atopic dermatitis in preschool children?.
Br J Dermatol, 144 (2001), pp. 514-522
[56.]
S. Weinmann, P. Kamtsiuris, K.D. Henke, M. Wickman, A. Jenner, U. Wahn.
The costs of atopy and asthma in children: assessment of direct costs and their determinants in a birth cohort.
Pediatr Allergy Immunol, 14 (2003), pp. 18-26
[57.]
J.M. Hanifin, K.D. Cooper, V.C. Ho, S. Kang, B.R. Krafchik, D.J. Margolis, et al.
Guidelines of care for atopic dermatitis.
J Am Acad Dermatol, 50 (2004), pp. 391-404
[58.]
C. Hoare, A. Li Wan Po, H. Williams.
Systematic review of treatments for atopic eczema.
Health Technol Assess, 4 (2000), pp. 1-191
[59.]
J. Berth-Jones, R.J. Damstra, S. Golsch, J.K. Livden, O. Van Hooteghem, F. Allegra, Multinational Study Group, et al.
Twice weekly fluticasone propionate added to emollient maintenance treatment to reduce risk of relapse in atopic dermatitis, double blind, parallel group study.
BMJ, 326 (2003), pp. 1367
[60.]
A. Peserico, G. Städtler, M. Seastian, R.S. Fernández, K. Vick, T. Bieber.
Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study.
Br J Dermatol, 158 (2008), pp. 801-807
[61.]
J.F. Stalder, M. Fleury, M. Sourisse, M. Rostin, F. Pheline, P. Litoux.
Local steroid therapy and bacterial skin flora in atopic dermatitis.
Br J Dermatol, 131 (1994), pp. 536-540
[62.]
Verbist I. The antimicrobial activity of fusidic acid. J Animicrob Chemother. 1990;25 Suppl B:1-5. In: Akdis CA, Akdis M, Biber T, Bindslev-Jensen C, Boquniewicz M, Eigenmann P, et al; European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Immunol. 2006;118: 152-69.
[63.]
D.M. Ashcroft, P. Dimmoc, R. Garside, K. Stein, H.C. Williams.
Efficacy and tolerability of topical pimecrolimus and tacrolimus in the treatment of atopic dermatitis: metaanalysis of randomised controlled trials.
BMJ, 330 (2005), pp. 516
[64.]
J. Yan, S.L. Chen, X.L. Wang, W. Zhou, F.S. Wang.
Meta-analysis of tacrolimus ointment for atopic dermatitis in pediatric patients.
Pediatr Dermatol, 25 (2008), pp. 117-120
[65.]
F.M. Arellano, C.E. Wentworth, A. Arana, C. Fernández, C.F. Paul.
Risk of lymphoma following exposure to calcineurin inhibitors and topical steroids in patients with atopic dermatitis.
J Invest Dermatol, 127 (2007), pp. 808-816
[66.]
M. Pitt, R. Garside, K. Stein.
A cost-utility analysis of pimecrolimus vs. topical corticosteroid and emollients for the treatment of mild and moderate atopic eczema.
Br J Dermatol, 154 (2006), pp. 1137-1146
[67.]
D. Breneman, A.B. Fleischer Jr, W. Abramovits, J. Zeichner, M.H. Gold, R.S. Kirsner, et al.
Intermittent therapy for flare prevention and long-term disease control in stabilized atopic dermatitis: a randomized comparison of 3-times-weekly applications of tacrolimus ointment versus vehicle.
J Am Acad Dermatol, 58 (2008), pp. 990-999
[68.]
T. Zuberbier, M. Bräugtigam.
Long-term management of facial atopic eczema with pimecrolimus cream 1% in paediatric patients with mild to moderate disease.
J Eur Acad Dermatol Venereol, 22 (2008), pp. 718-721
[69.]
R. Grimalt, V. Mengeaud, F. Cambazard, Study Investigator's Group.
The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study.
Dermatology, 214 (2007), pp. 61-67
[70.]
C.F. Wahlgren, A. Scheynius, O. Hagemark.
Antipruritic effect of oral cyclosporine A in atopic dermatitis.
Acta Derm Venereol, 70 (1990), pp. 323-329
[71.]
M.J. Korstanje, W.J.B.M. Van de Staak.
Cyclosporin maintenance therapy for severe atopic dermatitis.
Acta Derm Venereol, 71 (1991), pp. 356-357
[72.]
J.I. Harper, I. Ahmed, G. Barclay, M. Lacour, P. Hoeger, M.J. Cork, et al.
Cyclosporin for severe childhood atopic dermatitis: short course versus continuous therapy.
Br J Dermatol, 142 (2000), pp. 52-58
[73.]
J. Schmitt, N. Schmitt, M. Meurer.
Cyclosporin in the treatment of patients with atopic eczema-a systematic review and meta-analysis.
J Eur Acad Dermatol Venereol, 21 (2007), pp. 606-619
[74.]
J. Berth-Jones, A. Takwale, E. Tan, G. Barclay, S. Agarwal, I. Ahmed, et al.
Azathioprine in severe adult atopic dermatitis: a double-blind, placebo-controlled, crossover trial.
Br J Dermatol, 147 (2002), pp. 324-330
[75.]
M. Grundmann-Kollmann, M. Podda, F. Ochsendorf, W.H. Boehncke, R. Kauffmann, T.M. Zollner.
Mycophenolate mofetil is effective in the treatment of atopic dermatitis.
Arch Dermatol, 137 (2001), pp. 870-873
[76.]
K. Neuber, I. Schwartz, G. Itschert, A.T. Dieck.
Treatment of atopic eczema with oral mycophenolate mofetil.
Br J Dermatol, 143 (2000), pp. 385-391
[77.]
J. Schmitt, K. Schakel, N. Schmitt, M. Meurer.
Systemic treatment of severe atopic eczema: a systematic review.
Acta Derm Venereol, 87 (2007), pp. 100-111
[78.]
C. Grüber, M. Wendt, C. Sulser, S. Lau, M. Kulig, U. Wahn, et al.
Randomized, placebo-controlled trial of Lactobacillus rhamnosus GG as treatment of atopic dermatitis in infancy.
Allergy, 62 (2007), pp. 1270-1276
[79.]
A.L. Taylor, J.A. Dunstan, S.L. Prescott.
Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial.
J Allergy Immunol, 119 (2007), pp. 184-191
[80.]
A. Jacobi, C. Antoni, B. Manger, G. Schuler, M. Hertl.
Infliximab in the treatment of moderate to severe atopic dermatitis.
J Am Acad Dermatol, 52 (2005), pp. 522-526
[81.]
G. Guhl, B. Díaz-Ley, J. Fernández-Herrera.
Uso de fármacos biológicos in dermatosis fuera de la indicación aprobada. Segunda parte: etanercept, efalizumab, alefacept, rituximab, daclizumab, basiliximab, omalizumab y cetuximab.
Actas Dermosifiliogr, 80 (2007), pp. 38-40
[82.]
R. Takiguchi, S. Tofte, B. Simpson, E. Harper, A. Blauvelt, J. Hanifin, et al.
Efalizumab for severe atopic dermatitis: a pilot study in adults.
J Am Acad Dermatol, 56 (2007), pp. 222-227
[83.]
J.M. Weinberg, E.C. Siegfried.
Successful treatment of severe atopic dermatitis in a child and an adult with the T-cell modulator Efalizumab.
Arch Dermatol, 14 (2006), pp. 555-558
[84.]
J.E. Lane, J.M. Cheyney, T.N. Lane, D.E. Kent, D.J. Cohen.
Treatment of recalcitrant atopic dermatitis with omalizumab.
J Am Acad Dermatol, 54 (2006), pp. 68-72
[85.]
S.B. Forman, A.B. Garrett.
Success of omalizumab as monotherapy in adult atopic dermatitis: case report and discussion of the high-affinity immunoglobulin E receptor, Fc-epsilon-RI.
Cutis, 80 (2007), pp. 38-40
[86.]
R.A. Krathen, S. Hsu.
Failure of omalizumab for treatment of severe adult atopic dermatitis.
J Am Acad Dermatol, 53 (2005), pp. 338-340
[87.]
L.A. Beck, S. Saini.
Wanted: A study with omalizumab to determine the role of IgE-mediated pathways in atopic dermatitis.
J Am Acad Dermatol, 55 (2006), pp. 540-541
[88.]
R. Staughton.
Psychologic approach to atopic skin disease.
J Am Acad Dermatol, 45 (2001), pp. 53-54
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