New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview
Open accessAbstract
Atopic dermatitis (AD) is a complex disease with multiple causes and complex mechanistic pathways according to age of onset, severity of the illness, ethnic modifiers, response to therapy and triggers. A group of difficult-to-manage patients characterized by early-onset AD and severe lifelong disease associated with allergic asthma and/or food allergy (FA) has been identified. In this study, we focus on these severe phenotypes, analysing their links with other atopic comorbidities, and taking into account the results from recent cohort studies and meta-analyses. The main hypothesis that is currently proposed to explain the onset of allergic diseases is an epithelial barrier defect. Thus, the atopic march could correspond to an epithelial dysfunction, self-sustained by a secondary allergenic sensitization, explaining the transition from AD to allergic asthma. Furthermore, AD severity seems to be a risk factor for associated FA. Results from population-based, birth and patient cohorts show that early-onset and severe AD, male gender, parental history of asthma, and early and multiple sensitizations are risk factors leading to the atopic march and the development of asthma. The importance of environmental factors should be recognized in these high-risk children and prevention programs adapted accordingly. Effective targeted therapies to restore both barrier function and to control inflammation are necessary; early emollient therapy is an important approach to prevent AD in high-risk children. Clinicians should also keep in mind the specific risk of atopic comorbidities in case of filaggrin loss-of-function mutations and the rare phenotypes of orphan syndromes due to heritable mutations in skin barrier components.
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There are plausible biological pathways highlighting eczema as the initial stage in an atopic march, which can ultimately progress to asthma.
“Importantly, it should be acknowledged that there are plausible biological pathways that have been elucidated, highlighting eczema as the initial stage in an atopic march, which can ultimately progress to asthma [71].”
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Ricci, G., Dondi, A., Neri, I., Ricci, L., Patrizi, A., & Pession, A. (2014) · The Italian Journal of Pediatrics/Italian journal of pediatrics · doi:10.1186/1824-7288-40-46 · Cited by 17 · see citing works
Sach, T., McManus, E., Mcmonagle, C., & Levell, N. J. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0262-0 · Cited by 8 · see citing works
Burbank, A. J., & Burks, A. W. (2015) · PEDIATRICS · doi:10.1542/peds.2015-2776s · Cited by 7 · see citing works
Maas, T., Kaper, J., Sheikh, A., Knottnerus, J. A., Wesseling, G., Dompeling, E., Muris, J. W. M., & van Schayck, O. C. P. (2010) · Evidence-Based Child Health A Cochrane Review Journal · doi:10.1002/ebch.581 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Brunner, P. M., He, H., Pavel, A. B., Czarnowicki, T., Lefferdink, R., Erickson, T., Canter, T., Puar, N., Rangel, S. M., Malik, K., et al. (2019) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2019.04.036 · Cited by 109 · see citing works
Chong, Y. Y., Kwan, J. Y. M., Yau, P. T., Cheng, H. Y., & Chien, W. T. (2023) · Healthcare · doi:10.3390/healthcare11202708 · Cited by 6 · see citing works
“Importantly, it should be acknowledged that there are plausible biological pathways that have been elucidated, highlighting eczema as the initial stage in an atopic march, which can ultimately progress to asthma [71].”
Background
- Authors
- Amat, F., Soria, A., Tallon, P., Bourgoin‐Heck, M., Lambert, N., Deschildre, A., & Just, J.
- Affiliations
- Inserm (FR)
- Hôpital Armand-Trousseau (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Corresponding author
- Just, J.
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2018-05-24
- Volume
- 48
- Issue
- 8
- Pages
- 919-934
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2800421929
- Cited by
- 73
- References
- 91
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 10 · 2022: 16 · 2021: 13 · 2020: 9 · 2019: 6 · 2018: 1
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- atopic dermatitis, allergic asthma, food allergy, atopic march, epithelial barrier dysfunction, allergen sensitization, emollients, atopic comorbidities, risk factors
- MeSH terms
- Filaggrin Proteins, Age Factors, Allergens, Asthma, Dermatitis, Atopic, Disease Susceptibility, Food Hypersensitivity, Humans, Hypersensitivity, Immunization, Phenotype, Risk Factors, Severity of Illness Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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