Spergel Jonathan M, Paller Amy S
Division of Allergy and Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
J Allergy Clin Immunol. 2003 Dec;112(6 Suppl):S118-27. doi: 10.1016/j.jaci.2003.09.033.
Atopic dermatitis (AD), one of the most common skin disorders seen in infants and children, usually has its onset during the first 6 months of life. The prevalence of AD is similar in the United States, Europe, and Japan and is increasing, similar to that of other atopic disorders, particularly asthma. AD has been classified into 3 sequential phases: infantile, childhood, and adult, each with characteristic physical findings. AD has a tremendously negative effect on the quality of life of patients as well as family, most commonly disturbing sleep. The condition also creates a great financial burden for both the family and society. The cutaneous manifestations of atopy often represent the beginning of the atopic march. On the basis of several longitudinal studies, approximately half of AD patients will develop asthma, particularly with severe AD, and two thirds will develop allergic rhinitis. Epicutaneous sensitization has been thought to be responsible, with subsequent migration of sensitized T cells into the nose and airways, causing upper and lower airway disease. Animal models and human observation concur with this theory. Preliminary prevention studies with oral antihistamines provide evidence that early intervention might slow the atopic march.
特应性皮炎(AD)是婴幼儿中最常见的皮肤疾病之一,通常在出生后的头6个月内发病。在美国、欧洲和日本,AD的患病率相近且呈上升趋势,与其他特应性疾病(尤其是哮喘)类似。AD已被分为三个连续阶段:婴儿期、儿童期和成人期,每个阶段都有其特征性的体格检查结果。AD对患者及其家庭的生活质量有极大的负面影响,最常见的是干扰睡眠。这种疾病还给家庭和社会带来了巨大的经济负担。特应性的皮肤表现往往是特应性进程的开端。基于多项纵向研究,约一半的AD患者会发展为哮喘,尤其是重度AD患者,三分之二的患者会发展为过敏性鼻炎。人们认为表皮致敏是病因,致敏T细胞随后迁移至鼻腔和气道,导致上、下气道疾病。动物模型和人体观察均支持这一理论。口服抗组胺药的初步预防研究提供了证据,表明早期干预可能会减缓特应性进程。