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Phenotypic and Endotypic Determinants of Atopic Dermatitis Severity From the Atopic Dermatitis Research Network (ADRN) Registry.


ABSTRACT:

Background

Atopic dermatitis (AD) is a chronic inflammatory skin condition with a highly variable clinical phenotype.

Objective

This study aimed to identify historical and clinical features and biomarkers associated with AD severity.

Methods

A US registry of extensively phenotyped AD participants (aged 0.73-80 years) were enrolled at 9 academic centers. Information on family and personal medical history, examination, skin swabs (culture), and serum biomarkers was collected to evaluate their association with AD severity.

Results

Participants with AD (N = 2862) whose disease was categorized as mild (11.6%), moderate (58.0%), or severe (30.4%) based on Rajka-Langeland scoring were enrolled. The trend test, when adjusting for gender, race, and age, demonstrated that severity was strongly (P ≤ .04) associated with a personal/family history of allergic disorders, history of alopecia, exposure to passive smoke, ocular herpes infection, skin bacterial and viral infections, and history of arrhythmia. Features observed more frequently (P ≤ .002), as a function of severity, included skin infections (impetigo, human papillomavirus, and molluscum contagiosum virus), Staphylococcus aureus colonization, excoriations, hyperlinear palms, ichthyosis, blepharitis, conjunctivitis, ectropion, and wheezing. Serum IgE, allergen and food (≤6 years) Phadiatop, and eosinophilia were strongly linked to severity (P < .001).

Conclusions

In a diverse US AD population, severity was associated with a history of atopic disorders, skin and extracutaneous bacterial and viral infections (by history and physical examination), higher IgE, eosinophilia and allergen sensitization, atopic skin manifestations (ie, excoriation, hyperlinear palms, and ichthyosis), and atopic ocular features (ie, blepharitis, conjunctivitis, and ectropion) as well as asthma findings (ie, wheezing). Data from our prospective registry significantly advance our understanding of AD phenotypes and endotypes, which is critical to achieve optimal management.

SUBMITTER: Simpson EL 

PROVIDER: S-EPMC10524351 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Phenotypic and Endotypic Determinants of Atopic Dermatitis Severity From the Atopic Dermatitis Research Network (ADRN) Registry.

Simpson Eric L EL   De Benedetto Anna A   Boguniewicz Mark M   Ong Peck Y PY   Lussier Stephanie S   Villarreal Miguel M   Schneider Lynda C LC   Paller Amy S AS   Guttman-Yassky Emma E   Hanifin Jon M JM   Spergel Jonathan M JM   Barnes Kathleen C KC   David Gloria G   Austin Briahnna B   Leung Donald Y M DYM   Beck Lisa A LA  

The journal of allergy and clinical immunology. In practice 20230512 8


<h4>Background</h4>Atopic dermatitis (AD) is a chronic inflammatory skin condition with a highly variable clinical phenotype.<h4>Objective</h4>This study aimed to identify historical and clinical features and biomarkers associated with AD severity.<h4>Methods</h4>A US registry of extensively phenotyped AD participants (aged 0.73-80 years) were enrolled at 9 academic centers. Information on family and personal medical history, examination, skin swabs (culture), and serum biomarkers was collected  ...[more]

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