title: Atopic dermatitis phenotypes in childhood.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a chronic inflammatory skin disease and can be the first step of the atopic march.
  
  
  OBJECTIVE
  In this retrospective study, we analysed the immunological and clinical patterns of AD in a group of children affected by the disease since their first years of life, in order to evaluate if and how these patterns can change over time, and to identify biomarkers that can possibly correlate with the clinical phenotype.
  
  
  METHODS
  We enrolled Caucasian children with diagnosis of AD performed by a specialist on the basis of Hanifin and Rajka's criteria and with a first clinical and laboratory evaluation before 5 years of age. Patients were divided in 2 groups: IgE-associated AD (with or without allergic respiratory diseases) and non-IgE-associated AD.
  
  
  RESULTS
  Among 184 patients enrolled in this study, at the beginning 30/184 were classified as having non-IgE-associated AD, but during follow-up, at the median age of 36 months, 15 patients became allergic. All 15 patients who switched from the non-IgE to the IgE-associated form had a significantly earlier onset of AD than those who did not switch. Dust mite sensitization seem to be the best biomarker (OR 2.86) to predict the appearance of allergic respiratory diseases.
  
  
  CONCLUSIONS
  IgE-associated AD is more frequent in childhood than non-IgE-associated AD. These two phenotypes are different in the age of onset and in the remission patterns. In the first years of life, it is important to distinguish the different phenotypes in order to evaluate possible allergic related conditions.
authors.affiliation: Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. giampaolo.ricci@unibo.it.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Ricci
authors.forename: Arianna
authors.initials: A
authors.lastname: Dondi
authors.forename: Iria
authors.initials: I
authors.lastname: Neri
authors.forename: Lorenza
authors.initials: L
authors.lastname: Ricci
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology*; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010641:Phenotype; D012189:Retrospective Studies; D012882:Skin Tests; D013997:Time Factors
chemical_list: D000485:Allergens; D000888:Antibodies, Anti-Idiotypic; D007073:Immunoglobulin E