Atopic Dermatitis in Adults: A Diagnostic Challenge.

Area of Science:

• Dermatology
• Clinical Medicine

Background:

• Atopic dermatitis (AD) affects 1%-3% of adults, with adult-onset AD being a recently defined entity.
• Familiarity with adult-onset AD and its terminology remains limited, leading to diagnostic challenges.
• AD exhibits significant clinical heterogeneity, with presentations specific to adults, including head-and-neck dermatitis and chronic hand eczema.

Purpose of the Study:

• To provide an updated overview of adult atopic dermatitis clinical presentations.
• To propose a diagnostic approach for adult-onset atopic dermatitis.
• To emphasize the importance of accurate diagnosis for future treatment efficacy.

Main Methods:

• Review of clinical presentations of adult atopic dermatitis.
• Discussion of diagnostic challenges and criteria for adult-onset AD.
• Inclusion of diagnostic tests such as patch tests, prick tests, skin biopsies, and blood tests.

Main Results:

• Adult-onset AD often deviates from classic flexural patterns.
• Specific adult presentations include head-and-neck dermatitis, chronic hand eczema, lichenification, and prurigo lesions.
• Diagnosis can be challenging, often requiring exclusion and additional tests to differentiate from other eczemas.

Conclusions:

• Adult-onset atopic dermatitis requires specific diagnostic considerations beyond traditional pediatric criteria.
• A proposed diagnostic approach is essential for timely and accurate identification of adult AD.
• Correct diagnosis is a prerequisite for patients to benefit from emerging therapies for atopic dermatitis.