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Published on: September 26, 2019
Atopic dermatitis phenotypes in childhood
Giampaolo Ricci1, Arianna Dondi, Iria Neri
1Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. giampaolo.ricci@unibo.it.
Insights
Pediatric atopic dermatitis (AD) phenotypes evolve; distinguishing IgE-associated AD from non-IgE-associated AD early is crucial for predicting allergic conditions and guiding treatment.
Area of Science:
- Immunology
- Dermatology
- Pediatrics
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition.
- AD can be an initial manifestation of the atopic march, a progression of allergic diseases.
Purpose of the Study:
- To analyze immunological and clinical patterns of early-onset childhood AD.
- To evaluate changes in AD phenotypes over time.
- To identify biomarkers correlating with clinical presentation and predicting allergic outcomes.
Main Methods:
- Retrospective study of Caucasian children diagnosed with AD before age 5.
- Classification into IgE-associated AD and non-IgE-associated AD groups.
- Analysis of clinical and laboratory data during follow-up.
Main Results:
- Initially, 30/184 patients had non-IgE-associated AD; 15 later developed allergies.
- Patients switching from non-IgE to IgE-associated AD had an earlier disease onset.
- Dust mite sensitization is a significant biomarker (OR 2.86) for predicting allergic respiratory diseases.
Conclusions:
- IgE-associated AD is more common in childhood than the non-IgE form.
- AD phenotypes differ in onset age and remission patterns.
- Early differentiation of AD phenotypes is vital for managing associated allergic conditions.
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.
Conclusion:
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.
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