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Atopic dermatitis (AD)
Atopic dermatitis
Concept
Atopic dermatitis (AD) is a chronic skin disease related to genetic allergic diathesis and also a chronic, recurrent, inflammatory, and immunological disease of exudation tendency, and the symptoms include pruritus and pleomorphic skin lesion. Patients also show symptoms of asthma and allergic rhinitis; are allergic to heteroprotein; and suffer from serum IgE rising and peripheral eosinophils increasing.
Pathogenesis
Related to inheritance, susceptibility, and skin barrier dysfunction; Th1/Th2 imbalance is the main immune mechanism of disease onset.
Clinical manifestation
The onset manifestations are varied, including acute or chronic repeated attacks.
Patients with this disease at different ages show different clinical manifestations. In view of this, patients can be grouped into infantile, childhood, and young adulthood.

(1) Infantile AD occurs under 1 years old, mostly older than 2 months. The patients’ condition is waned and waxed, and can be worsened due to some food or certain environmental factors and followed by secondary infection.
(2) Childhood AD usually occurs and gradually worsens 1-2 years after remission of infantile AD, where a vicious circle of pruritus-scratching-pruritus may form.
(3) Young adulthood AD refers to teenagers older than 12 years old and adults, and can be developed from childhood AD or directly occur. The main affected parts include chelidon, popliteal fossa, limbs, and trunk. Intense pruritus is a prominent subjective symptom of the disease.
Therapeutic measures
(1) Topical medication therapy: glucocorticoid is the main drug for disease control and symptom relief. In recent years, calcineurin inhibitors for external use (tacrolimus ointment) are also found to be effective in treatment. JAK inhibitor and PDE4 inhibitor for external use appear to be more effective and safer.
(2) Systemic therapy: oral antihistamine helps relieving pruritus and reducing scratching; antibiotics should be prescribed in the case of secondary bacterial infection.
(3) Other treatment: desensitization treatment; phototherapy.