Review of atopic dermatitis:
epidemiological, physiopathological and therapeutic aspects
Atopic dermatitis (AD) is one of the most common inflammatory skin disorders. Its prevalence has doubled in the past 20 years. It is a combination of genetic factors and environmental factors. The current recommendations rely on an early first-line essential treatment of eczema lesions with dermocorticoids (DC). In case of failure, topical immunomodulators (TI) can be used instead. A daily maintenance treatment with emollients is fundamental to restore the cutaneous barrier. A proactive treatment using DC or TI also prolongs the eczema remissions.
Atopic dermatitis (AD) is one of the most common inflammatory skin disorders. It is characterized by recurring eczema lesions with intense pruritus and skin dryness. It especially affects infants and children, causing changes in their and their families’ quality of life.
I/ EPIDEMIOLOGICAL DATA
AD prevalence is 10-20% in developed countries where the socio-economic level is high (Europe, USA). It has doubled in the past 20 years. One of the reasons given (“hygienist theory”) is the improvement in infants’ living conditions. They are less exposed to infectious diseases (vaccinations and protected environment), which causes changes in immune system regulation leading to allergies. Increasing skin hygiene (daily bath) may also weaken an already defective skin barrier. An increase in AD prevalence and its cost for healthcare systems make it a public health issue.
Evaluating child populations in Western Europe, Northern Europe, the USA, and China using questionnaires during the last 15 years show how prevalence varies based on the country (see table on page 32).
In developed countri ...