Intrinsic Atopic Dermatitis and Extrinsic Atopic Dermatitis: Similarities and Differences

In atopic dermatitis (AD), recent research advances have portrayed a complex disease profile based on different subtypes/ phenotypes and underlying molecular mechanisms/endotypes. Extrinsic and intrinsic subdivision is one of the most common types, defined in terms of total serum immune globulin E (...

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Bibliographic Details
Published in:Clinical, cosmetic and investigational dermatology cosmetic and investigational dermatology, 2022-12, Vol.15, p.2621-2628
Main Authors: Liu, Lu, Song, Guoxuan, Song, Zhiqiang
Format: Article
Language:English
Subjects:
Adults
Advertising executives
Allergens
Antigens
Apoptosis
Atopic dermatitis
B cells
Chemokines
Cytokines
Dendritic cells
Dermatitis
Eczema
Epidemiology
epidermal barrier
Erythema
extrinsic atopic dermatitis
Females
Health care
Hormones
Hydration
immune dysfunction
immune globulin e
Immunoglobulin E
intrinsic atopic dermatitis
Ligands
Lymphocytes
Medical research
Medicine, Experimental
Mutation
Pediatrics
Precision medicine
Proteins
Skin
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Summary:In atopic dermatitis (AD), recent research advances have portrayed a complex disease profile based on different subtypes/ phenotypes and underlying molecular mechanisms/endotypes. Extrinsic and intrinsic subdivision is one of the most common types, defined in terms of total serum immune globulin E (IgE) and/or specific IgE to food and environmental allergens. Extrinsic AD is the most common type (80%), with high IgE, impaired skin barrier, as well as high incidence of comorbid atopic diseases, whereas intrinsic AD accounted for 20% of AD, with normal IgE and intact barrier function. Clinical studies have shown that extrinsic AD was a classic Th2-based inflammatory dermatitis, while the intrinsic subtype presented increased Th1/Th17/Th22 but normal Th2 cytokines. Protein sensitization, a classic Th2 response, has been clearly characterized in extrinsic AD, while metal hapten induces intrinsic AD's sensitization, which may be associated with suprabasin deficiency. In this review, we aimed to further expand our knowledge about similarities and differences between these two subtypes, which will expand our capability to further dissect pathophysiology of AD and enable us to develop personalized medicine approaches. Keywords: intrinsic atopic dermatitis, extrinsic atopic dermatitis, epidermal barrier, immune dysfunction, immune globulin E
ISSN:1178-7015
1178-7015
DOI:10.2147/CCID.S391360