Conflict of interest No conflicts of interest are present.
Atopic dermatitis in older patients: particular points
Article first published online: 21 JUN 2010
© 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 25, Issue 1, pages 12–18, January 2011
How to Cite
Katsarou, A. and Armenaka, M. (2011), Atopic dermatitis in older patients: particular points. Journal of the European Academy of Dermatology and Venereology, 25: 12–18. doi: 10.1111/j.1468-3083.2010.03737.x
- Issue published online: 3 DEC 2010
- Article first published online: 21 JUN 2010
- Received: 26 February 2010; Accepted: 20 April 2010
- atopic dermatitis;
We review the particular characteristics of atopic dermatitis (AD) in adult life, and compare findings with those of AD in childhood. AD affects 1–3% of adults world-wide, and can present as adult-onset AD, or as infantile/childhood AD that persists, or recurs after many years. Eczema in adults usually exists for years, compromising quality of life, sex life and occupational choices. The flexural areas, shoulders, head-and-neck, and hands are typically affected. In elderly adults, eczematous erythroderma is common. The intrinsic (non-IgE-allergic) eczema subtype affects 5–15% of cases. Classical food allergy has a low importance, although non-IgE-mediated and pseudoallergic reactions can cause eczema. Sensitivity to aeroallergens, especially dust mite, is demonstrated in the majority of adult AD patients, including elderly adults, by immunoglobulin E-mediated tests and/or atopy patch tests. Occupational allergic and irritant contact dermatitis is increased. In adults, as in children, Staphylococcus aureus colonization is very high, whereas adult skin is more heavily colonized with Malassezia yeasts. Immediate and delayed sensitization to Malassezia sympodialis is specific for intrinsic and extrinsic AD, occurring especially in head-and-neck eczema. Concerning therapy, older patients are prone to certain adverse drug effects. In conclusion, differences exist between childhood and adult disease. As we should be seeing more adults with AD in the future, there is a need for more clinical and immunological studies in older patients.