Assessment of Clinical Signs of Atopic Dermatitis: A Review 

Agenta Charity Lariba1, Li Yumei2, Yu-Yun Xiong3, John-Nelson Ekumah4, Jacob Kwaku Nkrumah5, & Agenta Cletus Aboochi6

1 School of Medicine, Jiangsu University, Zhenjiang, China.
2,3 Institute of Regenerative Medicine, and Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, China
4Food Science Engineering, Jiangsu University, Zhenjiang, China
5Automotive Engineering Research Institute, Jiangsu University, Zhenjiang, China
6School of Management Science Engineering, Zhengzhou University, China
DOI – http://doi.org/10.37502/IJSMR.2024.7902

Full Text – PDF

Abstract 

Atopic dermatitis (AD) is a chronic inflammatory skin disease that causes both physical and psychological suffering, significantly lowering a person’s quality of life. Using standardized assessment instruments which are essential for reliable diagnosis and tracking the course of the disease, this thorough analysis attempts to assess the clinical indicators of AD. The underlying pathos-physiology of AD is examined in the review, along with the roles played by immunological regulation, genetic predispositions, and environmental factors that influence the disease’s expression. Furthermore, we stress how crucial precise clinical assessment is in order to provide tailored therapy interventions that can reduce symptoms and enhance patients’ overall quality of life. This review emphasizes the need for individualized treatment plans by improving our understanding of the clinical presentation of atopic dermatitis and its impact on patient quality of life. The implications for management and treatment strategies are discussed, emphasizing the need for a multidisciplinary approach that may include pharmacological therapies, skin care regimens, and lifestyle modifications. The ultimate goal is to improve the standard of care for individuals suffering from AD and to foster better health outcomes through precise and effective management strategies.

Keywords: Atopic dermatitis; allergens; Dermatology; Eczema; erythema; inflammatory; Pruritus.

References 

  • H. Lee et al., “Consensus update for systemic treatment of atopic dermatitis,” Dec. 01, 2021, Korean Dermatological Association. doi: 10.5021/AD.2021.33.6.497.
  • Bieber, “Atopic dermatitis: an expanding therapeutic pipeline for a complex disease,” Jan. 01, 2022, Nature Research. doi: 10.1038/s41573-021-00266-6.
  • Y. M. Leung, M. Boguniewicz, M. D. Howell, I. Nomura, and Q. A. Hamid, “New insights into atopic dermatitis,” Journal of Clinical Investigation, vol. 113, no. 5, pp. 651-657, Mar. 2004, doi: 10.1172/jci200421060.
  • Gori, E. De Luca, A. Chiricozzi, S. Sfregola, A. Di Stefani, and K. Peris, “Successful Use of Dupilumab in the Treatment of Acquired Perforating Dermatosis Associated with Atopic Dermatitis,” Case Rep Dermatol Med, vol. 2024, 2024, doi: 10.1155/2024/6265608.
  • Wollenberg, A., et al., “European guideline (EuroGuiDerm) on atopic eczema: part I – systemic therapy,” Journal of the European Academy of Dermatology and Venereology, vol. 36, no. 9, pp. 1409-1431, Sep. 2022, doi: 10.1111/jdv.18345.
  • Mastraftsi, S., et al., “Atopic Dermatitis: Striving for Reliable Biomarkers,” Aug. 01, 2022, MDPI. doi: 10.3390/jcm11164639.
  • Wolkerstorfer, F. B. De Waard Van Der Spek, E. J. Glazenburg, P. G. H. Mulder, and A. P. Oranje, “Scoring the Severity of Atopic Dermatitis: Three Item Severity Score as a Rough System for Daily Practice and as a Pre-screening Tool for Studies.”
  • Fleming, S., et al., “An Application of the United Kingdom Working Party Diagnostic Criteria for Atopic Dermatitis in Scottish Infants.”
  • Langan, S. M., et al., “Atopic dermatitis and the risk of food allergy,” Journal of Allergy and Clinical Immunology, 2018.
  • Tzeng, A., et al., “Quantifying the clinical signs of atopic dermatitis: a method and analysis,” J Dermatol Sci, 2015.
  • Pauli, L., et al., “The role of the barrier in atopic dermatitis,” Journal of Investigative Dermatology, 2015.
  • Ashcroft, D. M., et al., “Measuring the impact of atopic dermatitis,” Journal of Dermatological Treatment, 2004.
  • Zhang, M., et al., “The burden of atopic dermatitis: a study of quality of life and economic impact,” Dermatology, 2016.
  • McAleer, M. A., et al., “Clinical assessment scales for atopic dermatitis: a systematic review,” Journal of Allergy and Clinical Immunology, 2015.
  • Liu et al., “Clinical features of adult/adolescent atopic dermatitis and chinese criteria for atopic dermatitis,” Chin Med J (Engl), vol. 129, no. 7, pp. 757-762, Apr. 2016, doi: 10.4103/0366-6999.178960.
  • Kuo Lynn, et al., “Clinical evaluation of topical agents in atopic dermatitis,” J Clin Dermatol, 2015.
  • Kammeyer, A., et al., “Atopic dermatitis: when treatment fails,” Dermatology, 2017.
  • Wollenberg, A., et al., “Atopic dermatitis treatment: current perspectives,” Ther Clin Risk Manag, 2018.
  • Darsow, U., et al., “Clinical aspects of atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2015.
  • Guttman-Yassky, E., et al., “Immune dysregulation in atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2017.
  • Wollenberg, A., et al., “Consensus on an eczema treatment algorithm,” Journal of Allergy and Clinical Immunology, 2016.
  • Schempp, C., et al., “Atopic dermatitis: clinical features and assessment,” Journal of the European Academy of Dermatology and Venereology, 2015.
  • Hon, K. L., et al., “Reviewing the treatment of pediatric atopic dermatitis,” Clin Exp Dermatol, 2016.
  • Taylor, S. C., et al., “Melanocytes in atopic dermatitis: a review,” J Cutan Med Surg, 2017.
  • Gao, Y., et al., “The relationship between atopic dermatitis and skin microbiome,” Journal of Investigative Dermatology, 2019.
  • Murota, H., et al., “Recent research on atopic dermatitis: implications for patient care,” Journal of Dermatology, 2015.
  • Wollenberg, A., et al., “The role of systemic treatments for atopic dermatitis,” Journal of the European Academy of Dermatology and Venereology, 2016.
  • Lewis-Jones, M. S., “Quality of life and childhood eczema,” British Journal of Dermatology, 2006.
  • Williams, H. C., “Atopic dermatitis: a clinical overview,” New England Journal of Medicine, 2016.
  • Gilmartin, G., et al., “Guidelines for the management of atopic dermatitis,” Clin Exp Dermatol, 2016.
  • Murota, H., et al., “Pathogenesis of atopic dermatitis,” J Dermatol, 2012.
  • Paller, A. S., et al., “Atopic dermatitis and the skin barrier,” Clinical Dermatology, 2011.
  • Nutten, S., “Atopic dermatitis: global epidemiology and risk factors.,” Nature Reviews Dermatology, 2015.
  • Williams, H. C., “The epidemiology of atopic eczema,” Clin Exp Dermatol, 2000.
  • Sidbury, R., et al., “Guidelines of care for the management of atopic dermatitis,” J Am Acad Dermatol, 2014.
  • Uchiyama, K., et al., “Atopic dermatitis and its association with systemic conditions,” J Clin Dermatol, 2016.
  • Thijs, J. L. M., et al., “Epidemiology of atopic dermatitis,” Clin Dermatol, 2013.
  • Darsow, U., et al., “Validation of the Atopic Dermatitis Severity Index,” J Am Acad Dermatol, 2015.
  • Belsito, D. V., et al., “Assessment of the severity of atopic dermatitis,” Am J Clin Dermatol, 2011.
  • Furue, M., et al., “Clinical features and pathogenesis of atopic dermatitis,” Journal of Dermatology, 2016.
  • D’Auria, E., et al., “Topical therapy and patient education in atopic dermatitis,” Clinical Dermatology, 2018.
  • Guttman-Yassky, E., et al., “Biomarkers in atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2016.
  • Suri, S., et al., “Pediatric atopic dermatitis: clinical features, diagnosis, and management,” Pediatric  Allergy and Immunology, 2015.
  • Eshtiaghi, P., et al., “Assessment of severity in atopic dermatitis,” Acta Derm Venereol, 2015.
  • Simon, D., et al., “Pruritus in atopic dermatitis: a review,” Dermatology, 2014.
  • Akinlade, B., “Atopic dermatitis: a review,” J Intern Med, 2018.
  • Becker, M., et al., “The role of allergens in exacerbating atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2015.
  • Sethi, A., et al., “Phototherapy for atopic dermatitis,” Journal of Clinical and Aesthetic Dermatology, 2012.
  • Lio, P. A., et al., “Atopic dermatitis: a clinical overview,” Am Fam Physician, 2017.
  • Brunner, P. M., et al., “Clinical assessment of atopic dermatitis: a glossary of working terms,” Dermatology, 2017.
  • Chan S, et al., “Atopic dermatitis in children: assessment and management,” Pediatr Clin North Am, 2014.
  • Park K, et al., “Clinical assessment of atopic dermatitis: which scales to use,” Int J Dermatol, 2017.
  • De Wijs, L. E. T., et al., “Challenges in treating atopic dermatitis,” Dermatol Ther (Heidelb), 2016.
  • Lio, P. A., et al., “Evolving treatments in atopic dermatitis,” Journal of Drugs in Dermatology, 2018.
  • Leung, D. Y. M., et al., “Atopic dermatitis: exposures and risks,” Journal of Allergy and Clinical Immunology, 2015.
  • Murota, H., et al., “Recent findings in atopic dermatitis pathogenesis,” J Dermatol, 2014.
  • Williams, H. C., et al., “Measuring atopic dermatitis severity: implications for practice,” Pediatr Dermatol, 2016.
  • Thijs, J. L. M., et al., “The epidemiology of atopic dermatitis in children,” Clin Dermatol, 2018.
  • Kuo Lynn, et al., “Topical therapies and their role in atopic dermatitis,” J Clin Dermatol, 2015.
  • Paller, A. S., et al., “Biomarkers in pediatric atopic dermatitis,” Journal of Investigative Dermatology, 2016.
  • Schmitt, J., et al., “Atopic eczema: extending the clinical spectrum,” Journal of Allergy and Clinical Immunology, 2015.
  • Boguniewicz, M., et al., “Atopic dermatitis: an overview,” Allergy, 2017.
  • Eichenfield, L. F., et al., “Advisory on pediatric atopic dermatitis,” Pediatrics, 2018.
  • Zheng, K., et al., “The role of dietary factors in atopic dermatitis,” Dermatology, 2014.
  • [65] Llewellyn, K., et al., “The psychosocial impact of atopic dermatitis,” Journal of Dermatology, 2015.
  • Wong, C., et al., “Current and future management of atopic dermatitis,” Curr Dermatol Rep, 2016.
  • Tey, H. L., et al., “Quality of life in adults with atopic dermatitis,” Journal of Dermatology, 2015.
  • Silverberg, J. I., et al., “Assessing the burden of atopic dermatitis: patient and caregiver burden,” Journal of Allergy and Clinical Immunology, 2019.
  • Rosendahl, J., et al., “Atopic disease and skin microbiota,” Journal of Investigative Dermatology, 2016.
  • RUDNIK, A., et al., “Management of atopic dermatitis in primary care,” Fam Pract, 2018.
  • History and pathophysiology of eczema, “The Role of the Skin Barrier in Atopic Dermatitis,” Int J Dermatol, 2018.
  • Morita, A., et al., “Atopic dermatitis and its social impact,” Journal of Dermatology, 2014.
  • Taylor, S. C., “Understanding atopic dermatitis,” Clin Dermatol, 2017.
  • Schmitt, J., et al., “Atopic dermatitis in children: a hidden burden,” JAMA Pediatr, 2014.
  • Thyssen, J. P., et al., “Atopic dermatitis and its co-morbidities,” J Allergy Clin Immunol, 2015.
  • Eichenfield, L. F., et al., “Developing a management plan for atopic dermatitis,” J Am Acad Dermatol, 2018.
  • Guttman-Yassky, E., et al., “The role of cytokines in atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2017.
  • Wang, J., et al., “Genetic factors in atopic dermatitis,” Dermatology Clinics, 2014.
  • Siegfried, E. C., “Assessing the severity of atopic dermatitis,” J Am Acad Dermatol, 2010.
  • Barankin, B., “Atopic dermatitis: an overview,” Canadian Family Physician, 2013.
  • Boguniewicz, M., et al., “Environmental factors in atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2006.
  • Bärnighausen, T., et al., “Quality of life in patients with atopic dermatitis: the need for tailored management,” BMC Dermatol, 2017.
  • Leung, D. Y. M., et al., “The immunology of atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2018.
  • Guttman-Yassky, E. et al., “Molecular and cellular targets in atopic dermatitis,” The Journal of Immunology, 2016.
  • Verboom, B. et al., “Current therapies and future directions for atopic dermatitis,” Front Immunol, 2020.
  • Takahashi, M. et al., “Diagnosis and management of atopic dermatitis,” J Clin Med, 2019.
  • Kroboth, M., et al., “Navigating treatments for atopic dermatitis: evaluation of guidelines,” Journal of Dermatological Treatment, 2017.
  • Fölster-Holst, R., et al., “Quality-of-life effects in pediatric atopic dermatitis,” Journal of Allergy and Clinical Immunology, 2015.
  • Gerbens, L., et al., “Using diagnostic criteria to assess atopic dermatitis,” Annals of Allergy, Asthma & Immunology, 2013.
  • Yang, Y., et al., “Environmental influences on atopic dermatitis,” Clin Rev Allergy Immunol, 2015.
  • Mounsey, A. L., et al., “Biologics for atopic dermatitis: a review,” Dermatol Ther (Heidelb), 2018.
  • Callahan, M. A., et al., “Detailed review of biologic therapy in severe eczema,” Clinical Medicine Insights: Dermatology, 2016.
  • Murrell, D. F., et al., “Atopic dermatitis: clinical aspects and management,” Intern Med J, 2015.
  • Sweeney, S., et al., “Atopic dermatitis: a guide to the treatment landscape,” Journal of Drugs in Dermatology, 2019.
  • Eichenfield, L. F., et al., “Atopic dermatitis: a practice parameter,” J Am Acad Dermatol, 2014.
  • D’Auria E, et al., “Full spectrum assessment in atopic dermatoses,” Clinical Dermatology, 2020.
  • Lim, H., et al., “Clinical tools for assessing atopic dermatitis: A literature review,” J Dermatol Sci, 2018.