Textbook of Atopic Dermatitis PDF

Preface

Atopic dermatitis (AD) is a common disorder which affects infants, children and adults throughout the world with a high socio-economical impact and a broad relevence on the quality of life of these patients. Typical for AD is eczema, a superficial inflammation of the skin. For dermatologists, AD is primarily a clinical diagnosis, which is based on the features suggested by Hanifin and Rajka. In this classification, patients who have no signs of sensitization for environmental antigens, and hence normal immunoglobulin E levels in the serum, are included. New studies suggest that these patients may include up to 50% of the patients with AD, when population-based studies are performed. In contrast, classification by allergologists suggest that AD as a disease where sensitization and hence raised IgE levels plays a central role.

Recent knowledge on common mutations of proteins, especially those of the outer layer of the skin, such as filaggrin, suggest that the skin barrier function in AD can be impaired by both genetic defects in the structure of the skin and the immunological inflammation of AD. Studies both in mouse and man suggest that that a proper barrier function is important not only for the skin but also for the airways. Moreover, the function and regulation of the peripheral as well as central nervous system has been demonstrated to be altered in patients with AD. Thus, this book aims at highlighting our recent advances in understanding the complex interactions between the tissue barrier, the immune and the nervous system.

Treatment of AD remains a challenge. While treatment with topical corticosteroids still forms the primary treatment, long-term data of this treatment is still not sufficient. Ultraviolet therapy and oral immunosuppressive treatment are needed especially in the more severe cases of AD. These treatments are capable of reducing but not replacing corticosteroid treatment. Topical calcineurin inhibitors represent a new treatment alternative which in many cases can totally substitute treatment with topical corticosteroids.

This book gives a broad and intense overview about the clinical manifestations, the pathogenesis as well as present and future treatment modalities of AD. It is aimed to teach both the academic as well as practising dermatologist. We want to thank the publisher for their contribution in putting this book together. The central role of Robert Peden is greatfully acknowledged. We also gratetful for the expertise of all authors who contributed to make this work possible.