ATOPIC D[RMATITIS editea by T~om~s Bieber University of Bonn Bonn, Germany Don~ld Y. M.leung National Jewish Medical and Research Center Denver, Colorado MARCELn MARCEL DEKKER, INC. D E K K E R NEW YORK' BASEL Copyright © 2002 by Marcel Dekker, Inc. All Rights Reserved. ISBN: 0-8247-0742-7 This book is printed on acid-free paper. Headquarters Marcel Dekker, Inc. 270 Madison Avenue, New York, NY 10016 tel: 212-696-9000; fax: 212-685-4540 Eastern Hemisphere Distribution Marcel Dekker AG Hutgasse 4, Postfach 812, CH-4001 Basel, Switzerland tel: 41-61-261-8482; fax: 41-61-261-8896 World Wide Web http://www.dekker.com The publisher offers discounts on this book when ordered in bulk quantities. For more information, write to Special Sales/Professional Marketing at the headquarters address above. Copyright © 2002 by Marcel Dekker, Inc. All Rights Reserved. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher. Current printing (last digit): 10 9 8 7 6 5 4 3 2 I PRINTED IN THE UNITED STATES OF AMERICA Preface iii u .E ~8 ! @ -§, .~ 8 MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? Atopic dermatitis is one of the most common skin conditions found in the general population. Patients afflicted with skin disease suffer greatly as it adversely af- fects their quality of life. This book offers a new, integrating view of all aspects relevant to the complex pathophysiology of this disorder. Each chapter provides a comprehensive and up-to-date review of a particular field of research and also considers links to other pathomechanisms of this disease. All aspects-especially the newest immunoallergological and biochemical concepts-are thoroughly dis- cussed with regard to established, experimental, and potential new therapeutical strategies. The book is divided into several parts to make a clear presentation of the various aspects of this disease. Part I examines the impact of atopic dermatitis, addressing the epidemiological, psychological, and socioeconomic effects of this disease. A distinction is also made between allergic vs. non-allergic atopic derma- titis. Part II provides an overview of the general mechanisms with in-depth dis- cussions on the immunogenetics, risk factors, skin barrier function, and immuno- logic basis of atopic dermatitis including the pathophysiology of itching, which is the most prominent feature of this skin disease. Part III focuses on the individ- ual cell types that contribute to atopic dermatitis and therefore provides potential therapeutic targets for intervention. Part IV reviews the immunologic triggers (foods, inhalants, bacteria, and fungi) that aggravate atopic dermatitis, and dis- cusses how to prevent them from becoming such a problem. The final part of the book deals with management. How should skin care be approached? What is the current state of the art in treatment and what new treatments are on the horizon? As atopic dermatitis is a highly prevalent skin disease and provides impor- iv Preface tant insights into mechanisms of allergic skin immune responses, clinicians from many specialties, including dermatologists, allergists, family practitioners, and pediatricians as well as medical students and experimental investigators will ben- efit from this work, which gives the information necessary for understanding the modern management of atopic dermatitis. Thomas Bieber Donald Y. M. Leung u .E ~8 ) @ .§, .~ 8 MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? Contents Preface Contributors iii IX Part I: IMPACT OF ATOPIC DERMATITIS 1. Definition and Diagnosis of Intrinsic Versus Extrinsic Atopic Dermatitis Brunello Wiithrich and Peter Schmid-Grendelmeier 2. Epidemiology 21 Carolyn R. Charman and Hywel C. Williams 3. Psychoimmunology and Evaluation of Therapeutic Approaches 43 Uwe Gieler, Volker Niemeier, and Burkhard Brosig -ci"1:: ~ ~ il OJ) '1: 81 ~u .E ..: ~ III " 0 OJ ~ V ~ Q> ~ .~ '" 0u 6. Risk Factors for Atopic Dermatitis Erika von Mutius 4. Socioeconomic Impact of Atopic Dermatitis 67 Candace S. Lapidus and Philip E. Kerr 5. Genetics of Atopic Dermatitis Kate Elliott and Susan Forrest Part II: GENERAL MECHANISMS MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? vi 7. Epidenna1 Barrier in Atopic Dennatitis Ehrhardt Proksch and Peter M. Elias 8. Mechanisms of Allergic Skin Inflammation Miibeccel Akdis, Axel Trautmann, Kurt Blaser, and Cezmi A. Akdis 9. Animal Models of Atopic Dermatitis Udo Herz, Ulrike Raap, and Harald Renz 10. Pathophysiology of Pruritus Sonja Stander, Martin Steinhoff, and Thomas A. Luger Part III: CELLULAR ASPECTS 11. Cellular Aspects of Atopic Dermatitis: Overview Haydee M. Ramirez, Kefei Kang, Seth R. Stevens, and Kevin n. Cooper Contents ]23 145 163 183 217 12. Keratinocytes 231 Giampiero Girolomoni, Alberto Giannetti, and Saveria Pastore ]3. T Cells in Atopic Dermatitis Thomas Weifel and Alexander Kapp 14. Antigen-Presenting Cells Andreas Wollenberg and Thomas Bieber ]5. Mast Cells and Basophils Naotomo Kambe, Anne-Mane Irani, and Lawrence B. Schwartz 16. Eosinophils and Atopic Dermatitis Kristin M. Leifemwn, Douglas A. Plager, and Gerald J. Gleich Part IV: IMMUNOLOGICAL TRIGGERS AND INTERVENTION 241 267 285 327 357 17. Aeroallergens Elizabeth A. Erwin and Thomas A. E. Platts-Mills oj ..:l M ) @ -§, .~ 8 MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? Contents 18. Atopic Dennatitis and Foods Lisa Ellman-Grunther and Hugh A. Sampson 19. Role of Staphylococcus aureus in Atopic Dermatitis Donald Y. M. Leung 20. Fungal Allergens Hachiro Tagami, Hiroaki Aoyama, Mikiko Okada, and Tadashi Terui Part V: MANAGEMENT 21. Allergy Diagnosis in Atopic Eczema with the Atopy Patch Test Ulf G. Darsow and Johannes Ring 22. Conventional Topical Treatment of Atopic Dermatitis Mark Roguniewicz 23. Special Aspects in Pediatric Patients Christine Bodemer and Yves de Prost 24. Role of Cyclic Nucleotide Phosphodiesterases in Atopic Dennatitis Luis F. Santamaria 25. Phototherapy for Atopic Dennatitis Jean Thomas Krutmann and Akimichi Morita 26. The Psychological Aspects of Atopic Dermatitis Caroline S. Koblenzer 27. Topical Macrolide Immunomodulators for Therapy of Atopic Dennatitis Sakari Reitamo 28. Chinese Herbal Therapy in Atopic Dermatitis John R. Reed and Malcolm H. A. Rustin 29. Systemic Phannacotherapy Werner Aberer and Klaus Wolff vii 375 401 419 437 453 479 491 501 519 541 -ci" ~ ~ 567 i '1:: ~ U 589 ..s ..: ~" 0 " ~ ::E <Ql .§, '1::» c:>.c U MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? viii Part VI: THE FUTURE 30. Future Perspectives in Atopic Dermatitis Thomas Bieber and Donald Y. M. Leung Index Contents u .E ~8 ) @ -§, .~ 8 MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? Contributors Werner Aberer Department of Dermatology, University of Graz, Graz, Aus- tria Cezmi A. Akdis Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland Miibeccel Akdis Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland Hiroaki Aoyama Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan Thomas Bieber Department of Dermatology and Allergology, University of Bonn, Bonn, Germany Kurt Blaser Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland Christine Bodemer Service de Dennatologie, H6pital Necker Enfants Ma- lades, Paris, France Mark Boguniewicz National Jewish Medical and Research Center, and De- partment of Pediatrics, University of Colorado School of Medicine, Denver, Colorado ix MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? x Contributors Burkhard Brosig Department of Psychosomatic Dennatology, Justus Liebig University Giessen, Giessen, Gennany Carolyn R. Charman Department of Dermatology, Queen's Medical Centre, University Hospital, Nottingham, United Kingdom Kevin D. Cooper Department of Dennatology, University Hospitals of Cleve- land, and Case Western Reserve University, Cleveland, Ohio Ulf G. Darsow Department of Dennatology and Allergy Biederstein, Technical University Munich, Munich, Germany Yves de Prost Service de Dennatologie, Hopital Necker Enfants Malades, Paris, France Peter M. Elias Department of Dennatology, University of California, San Francisco, California Kate Elliott Murdoch Childrens Research Institute, Melbourne, Australia Lisa Ellman-Grunther Department of Allergy and Immunology, Mount Sinai School of Medicine, New York, New York Elizabeth A. Erwin Department of Internal Medicine, University of Virginia, Charlottesville, Virginia Susan Forrest Murdoch Childrens Research Institute, Melbourne, Australia Alberto Giannetti Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy Uwe Gieler Department of Psychosomatic Medicine, Justus Liebig University Giessen, Giessen, Gennany * CurrenJ affiliation: Department of Dermatology, University of Utah, Salt Lake City, Utah. u..s ~8 ] ::E iQl .§, .~ 8 MARCEL DEKKER, INC. ~ 270 Madison Avenue. New York. New York 10016 IU? Giampiero Girolomoni Second Division of Dermatology and Laboratory of Immunology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy Gerald J. Gleich* Department of Immunology, Mayo Clinic and Mayo Foun- dation, Rochester, Minnesota