Phenotypes of atopic dermatitis

Abstract

This review summarizes the current understanding of the phenotypes (clinical manifestations) of atopic dermatitis based on morphological and some laboratory diagnostic tools (total IgE level, sensitization status, filaggrin mutations). The author gives a chronology of the study of atopic dermatitis phenotypes, including the use of modern statistical methods (clusters). Recent studies have described unique phenotypes in patients with atopic dermatitis colonized by Staphylococcus aureus; in patients with atopic dermatitis and food allergies; in patients with herpes eczema, including a history of herpes infection. At the same time, it is quite obvious that phenotypes are determined by molecular mechanisms (endotype), which are associated with the age of patients, the severity of the disease, persistence, etc. Recently, publications have appeared that confirmed the features of the course of the disease in different ethnic groups (European-American and Asian phenotypes), including immunopathogenetic differences characteristic of different races of people. Together, studies on the endo- and phenotypes of atopic dermatitis will help to better identify the most optimal approach to personalized treatment of these patients. Ultimately, such studies are important for developing a classification of atopic dermatitis phenotypes.