Atopic Dermatitis in Childhood and Adolescence

Description

Atopic dermatitis is amongst the most common disorders of the skin in young people around the world. This timely book presents the newest insights and novel concepts in relation to all aspects of this skin disorder. Classification, clinical features and differential diagnosis are reviewed in the first chapter, while risk factors, susceptibility and an epidemiological overview are outlined in the next chapter, followed by a detailed discussion of the immunology of the skin and the pathophysiology of dermatitis. Further chapters present exciting new data delineating clinical aspects of current genetic findings and insights into concepts of neuroimmunology, as well as the very crucial and severe clinical aspect of itching. New data on the topic of inhalant allergy, specific immunologic treatments and the latest on food allergy are also included. A valuable reference for anyone interested in atopic dermatitis, this book is particularly useful for pediatricians and clinical practitioners seeing children and adolescents with atopic dermatitis on a daily basis.

Informations

• Publié par: S. Karger AG
• Date de parution: 05 septembre 2011
• Nombre de lectures: 0
• EAN13: 9783805595711
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Atopic Dermatitis in Childhood and Adolescence
Pediatric and Adolescent Medicine
Vol. 15
Series Editors
Wieland Kiess    Leipzig
David Branski    Jerusalem
 
 
Atopic Dermatitis in Childhood and Adolescence
Volume Editors
Thomas Werfel    Hannover
Jonathan M. Spergel    Philadelphia
Wieland Kiess    Leipzig
14 figures, 8 in color and 18 tables, 2011
Pediatric and Adolescent Medicine
________________
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Thomas Werfel Medizinische Hochschule Hannover Klinik für Dermatologie, Allergologie und Venerologie Abteilung Immundermatologie und experimentelle Allergologie D-30449 Hannover Germany
Jonathan M. Spergel Department of Pediatrics Division of Allergy and Immunology Children's Hospital of Philadelphia Philadelphia, PA 19104 USA
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Wieland Kiess Department of Women and Child Health Hospital for Children and Adolescents University of Leipzig D-04103 Leipzig Germany
Library of Congress Cataloging-in-Publication Data
Atopic dermatitis in childhood and adolescence/volume editors, Thomas Werfel, Jonathan M. Spergel, Wieland Kiess.
p.; cm. -- (Pediatric and adolescent medicine, ISSN 1017-5989 ; v. 15)
Includes bibliographical references and index.
ISBN 978-3-8055-9570-4 (alk. paper) -- ISBN 978-3-8055-9571-1 (e-ISBN)
1. Atopic dermatitis. 2. Pediatric dermatology.
I. Werfel, Thomas. II. Spergel, Jonathan M. III. Kiess, W. (Wieland) IV. Series: Pediatric and adolescent medicine; v. 15 ; 1017-5989
[DNLM: 1. Dermatitis, Atopic. 2. Adolescent. 3. Child. W1 PE163HL v. 15 2011/WR 160]
RJ516.A86A86 2011
618.92'5--dc23
2011022403
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2011 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 1017-5989
ISBN 978-3-8055-9570-4
e-ISBN 978-3-8055-9571-1
 
 
Contents
VII Preface
Werfel, T. (Hannover); Spergel, J. (Philadelphia, Pa.); Kiess, W. (Leipzig)
1 Classification, Clinical Features and Differential Diagnostics of Atopic Dermatitis
Werfel, T. (Hannover)
11 Risk Factors and Epidemiology
Schäfer, T. (Immenstadt)
21 Clinical Impact of Current Genetics Findings
Weidinger, S. (Munich); Kabesch, M. (Hannover)
39 Immunology and Pathophysiology of Atopic Dermatitis
Bussmann, C.; Bieber, T.; Novak, N. (Bonn)
50 Psychological Factors of Atopic Dermatitis
Raap, U. (Hannover); Schmid-Ott, G. (Löhne)
56 Neuroimmunology and Itch of Atopic Dermatitis
Raap, U.; Kapp, A. (Hannover)
64 Role of Food Allergy in Atopic Dermatitis
Spergel, J.M. (Philadelphia, Pa.)
82 Inhalant Allergy
Wichmann, K.; Heratizadeh, A. (Hannover)
90 Infections and Bacterial Colonization Including Treatment
Niebuhr, M. (Hannover)
101 Topical Treatment of Atopic Dermatitis
Miehe, U.; Kiess, W.; Prenzel, F. (Leipzig)
113 Systemic Therapies in Pediatric Atopic Dermatitis
Shah, K.N.; Yan, A.C. (Philadelphia, Pa.)
133 Occupational Aspects
Breuer, K. (Hamburg); John, S.M. (Osnabrück)
149 Educational Programs for Children with Atopic Dermatitis and Their Parents
Staab, D.; Wahn, U. (Berlin)
158 Author Index
159 Subject Index
 
 
Preface
New insights have been obtained over the last years in relation to all aspects of atopic dermatitis. It is therefore timely to include a book on atopic dermatitis in the series Pediatric and Adolescent Medicine. Atopic dermatitis is amongst the most common skin disorders in young people around the world. Novel concepts are emerging on the management and treatment of atopic dermatitis as well as its epidemiology, pathophysiology and genetics. Classification, clinical features and differential diagnoses are revisited in the first chapter by Thomas Werfel, Hannover. Risk factors, susceptibility and an overview in relation to epidemiology are outlined in an excellent chapter by Torsten Schaefer. Stephan Weidinger and Michael Kabesch comment on the very exciting new data delineating the clinical aspects of current genetic findings. The group of Natalija Novak and Thomas Bieber from Bonn addresses the topic of immunology of the skin and the pathophysiology of dermatitis. Psychological factors are known to play a role both in the development and maintenance of atopic dermatitis. Concepts on how to address psychological factors in children and adolescents with atopic dermatitis are discussed by Ulrike Raap and her colleagues. They also present insights into the concepts of neuroimmunology and the very crucial and severe clinical aspect of itching. In his excellent chapter, Jonathan Spergel from Philadelphia presents the latest knowledge on food allergy, while Katja Wichmann from Hannover presents new data on the topic of inhalant allergy and specific immunologic treatments.
Infections and bacterial colonization of the skin is nicely discussed in the chapter by Margarete Niebuhr, again from Hannover. Ulrich Miehe from the University of Leipzig describes the many aspects of topical treatments. This chapter makes the volume of particular value for the clinical practitioner seeing children and adolescents with atopic dermatitis on a daily basis. Systemic treatments are discussed by A. Yan from the Children's Hospital of Philadelphia. Lastly, two crucial aspects of this chronic condition are presented: K. Breuer from Hamburg concerns himself with occupational aspects and work place restrictions, while the group of Doris Staab and Ulrich Wahn from the Charité, Berlin, report on the importance, effectiveness as well as the practical aspects of educational programs. The editors are very grateful to all authors who have put together a volume of both an impressive scientific content and high practical value. We wish to thank Gabriella and Dr. Thomas Karger and their excellent staff at Karger Publishers in Basel, Switzerland, for giving us the opportunity to edit this book.
Thomas Werfel , Hannover
Jonathan Spergel , Philadelphia
Wieland Kiess , Leipzig
 
 
Werfel T, Spergel JM, Kiess W (eds): Atopic Dermatitis in Childhood and Adolescence. Pediatr Adolesc Med. Basel, Karger, 2011, vol 15, pp 1-10
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Classification, Clinical Features and Differential Diagnostics of Atopic Dermatitis
Thomas Werfel
Medizinische Hochschule Hannover, Klinik für Dermatologie, Allergologie und Venerologie, Abteilung Immundermatologie und experimentelle Allergologie, Hannover, Germany
Classification of Atopic Dermatitis
Classification by Means of Allergic Sensitization
Atopic dermatitis (AD) is characterized by severe pruritus, a chronically relapsing course, a distinctive distribution of eczematous skin lesions, and a personal or family history of atopic diseases. It often begins in early infancy and follows a course of remissions and exacerbations. The role of exogenous and endogenous factors in the pathophysiology of AD has been intensively discussed in recent years. There is increasing evidence that T cell responses to environmental or food allergens are important for the pathogenesis of AD. In patients with AD, the skin disease is most often associated with the existence of environmental or food allergen-specific IgE. This variant of the disease, which is also associated with environmental allergenspecific IgE, is usually called the ‘extrinsic’ form of AD. The 'intrinsic' variant is found in 20% of diseases with the typical clinical appearance of AD but without specific IgE [ 1 ].
In this respect, AD resembles bronchial asthma: Indeed, this dichotomy of extrinsic versus intrinsic was first used for asthma. The terminology of extrinsic or allergic asthma was first introduced by Rackeman in 1947 and referred to the triggering role of allergens in asthma. As intrinsic asthmatic patients appeared not to be