WAO Medical Book Review
Posted: December 2013
Atopic Dermatitis - Disease Etiology and Clinical Management
Edited by Jorge Esparza-Gordillo and Itaru Dekio
Copyright 2012 The Authors and Editors
Published by InTech, 22 February 2012
Juan Carlos Aldave, MD
Hospital Nacional Edgardo Rebagliati Martins
Division of Allergy and Immunology
Atopic dermatitis is a common chronic inflammatory skin disease with multiple pathogenic factors and variable clinical presentations. Its prevalence has increased worldwide, representing an important public health issue. Early diagnosis and appropriate treatment of patients can significantly improve quality of life, prevent major complications, and reduce socio-economic burden.
Despite the recent advances in medicine, an important proportion of patients with atopic dermatitis remain undiagnosed or inappropriately treated. An additional group of subjects report significant bothersome symptoms even with guideline-based therapy. As a need to overcome these problems, the current book offers valuable knowledge regarding pathogenic factors, diagnostic tools, and therapeutic alternatives for atopic dermatitis which will aid the treating physician to successfully care for affected individuals.
The content is organized into 4 sections and 22 chapters. The first and second sections describe some genetic and environmental pathogenic factors of atopic dermatitis including (a) skin barrier defects (e.g., filaggrin gene defect); innate immune dysregulation (e.g., decreased production of antimicrobial peptides); (b) adaptive immune dysregulation (e.g., increased TH2 and TH22 responses, reduced T-cell regulatory responses); (c) exaggerated immune responses against food allergens (e.g., milk, egg), aeroallergens (e.g., house dust mites), microbial antigens (e.g., Staphylococcus aureus or Malassezia sp), or self antigens (e.g., human thioredoxin); and (d) abnormal skin colonization by microorganisms.
The third section provides detailed information about current diagnosis and management protocols of atopic dermatitis. Clinical history and allergologic/microbiologic laboratory tests represent the mainstay of diagnosis. Emollients and anti-inflammatory drugs remain as the two main therapeutic pillars.
The last section describes new therapeutic alternatives for atopic dermatitis. A futuristic approach to manage, or even prevent, the disease consists of stratifying the patients according to clinical, laboratory, histologic and genetic markers, which would allow the treating physician to use an individualized approach to management
Assessment and Audience
This comprehensive overview of the pathogenic factors, epidemiology, diagnosis and treatment of atopic dermatitis will provide practical information for the general practitioner, pediatrician, dermatologist, laboratory researcher and student interested in this disease.