Characterization of different courses of atopic dermatitis in adolescent and adult patients
Characterization of different courses of atopic dermatitis in adolescent and adult patients
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DOI：
10.1111/all.12112
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发表时间：
2013-04-01
期刊：
影响因子：
12.4
通讯作者：
Novak, N.
中科院分区：
文献类型：
--
作者：
Garmhausen, D.;Hagemann, T.;Novak, N.
特应性皮炎（AD）最常见于生命的头几年，并在儿童时期进入缓解期的病例占很大比例。然而，在严重的情况下，阿尔茨海默病会持续到成年或在生命后期开始和复发。到目前为止，研究阿尔茨海默病在青春期和成年期的自然过程的研究很少。我们研究的目的是对不同病程的阿尔茨海默病进行分类，并将它们与阿尔茨海默病严重变体的特定危险因素联系起来。方法对725例青少年和成人AD患者进行详细的临床检查和病史回顾性评价。评估实验室数据，包括总IgE和特异性IgE。结果725例患者中有670例可分为病程类型。607例患者中，85.7%的患者可分为5种主要的不同病程类型。在早发型AD和慢性病程持续到成年的患者和晚发型AD（即20岁以后）患者之间，观察到致敏次数、总免疫球蛋白E血清水平和皮肤病变偏好的最大差异。结论阿尔茨海默病的自然病程可分为不同的亚组，表现出不同的临床特征。这些数据支持了阿尔茨海默病在青少年和成年期存在广泛异质性的假设，并强调了未来对阿尔茨海默病患者进行仔细分层的必要性。
Background Atopic dermatitis (AD) starts most often during the first years of life and goes into remission in a high proportion of cases during childhood. However, in severe cases, AD persists until adulthood or starts and relapses later in life. So far, studies investigating the natural course of AD during adolescence and adulthood are rare. The aim of our study was to classify different courses of AD and to correlate these with specific risk factors for severe variants of AD. Methods A detailed clinical examination and retrospective evaluation of the history of the disease were performed in a collective of 725 adolescent and adult patients with AD. Laboratory data including total and specific IgE were evaluated. Results Six hundred and seven patients of 725 patients could be classified into course types. Of these 607 patients 85.7% could be classified into five main different course types of all 31 course types recorded. The highest differences in the number of sensitizations, total immunoglobulin E serum levels and predilection of the skin lesions were observed between patients with an early type of onset of AD and a chronic persisting course until adulthood and patients with a late type of onset of AD, that is, after the 20th year of life. Conclusion Our data show that the natural course of AD can be divided into subgroups that display different clinical features. The data support the assumption of a broad heterogeneity of AD in adolescence and adulthood and emphasize the future need for careful stratification of patients with AD.