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Abstract
Atopic dermatitis (AD), one of the most common skin disorders seen in infants and
children, usually has its onset during the first 6 months of life. The prevalence
of AD is similar in the United States, Europe, and Japan and is increasing, similar
to that of other atopic disorders, particularly asthma. AD has been classified into
3 sequential phases: infantile, childhood, and adult, each with characteristic physical
findings. AD has a tremendously negative effect on the quality of life of patients
as well as family, most commonly disturbing sleep. The condition also creates a great
financial burden for both the family and society. The cutaneous manifestations of
atopy often represent the beginning of the atopic march. On the basis of several longitudinal
studies, approximately half of AD patients will develop asthma, particularly with
severe AD, and two thirds will develop allergic rhinitis. Epicutaneous sensitization
has been thought to be responsible, with subsequent migration of sensitized T cells
into the nose and airways, causing upper and lower airway disease. Animal models and
human observation concur with this theory. Preliminary prevention studies with oral
antihistamines provide evidence that early intervention might slow the atopic march.