Korean J Dermatol.  2022 Jan;60(1):16-24.

Characteristics of Atopic Dermatitis according to Common Phenotypes

• Lee DG
• Lee KJ
• Kang H
• Kim JE

Abstract

Background
The incidence of atopic dermatitis has been increasing and the condition is known to present with different phenotypes. As response to treatment varies from patient to patient, many attempts have been made to classify atopic dermatitis into different clinical phenotypes and endophenotypes to personalize treatment.
Objective
This is a pilot study that aims to classify atopic dermatitis into common clinical phenotypes and associate each of the phenotypes with clinical characteristics and laboratory findings.
Methods
A total of 186 adult atopic dermatitis patients were classified into four clinical phenotypes: lichenoid/exudative, nummular, prurigo-nodularis, and erythrodermic. We compared baseline characteristics, disease severity, laboratory test results, associated symptoms, and lesional location between the phenotypes.
Results
The age was lower, and proportion of very early onset group was higher in lichenoid/exudative type. Eczema Area and Severity Index score was significantly lower in nummular type patients. Total immunoglobulin E and eosinophilic cationic protein values were higher in lichenoid/exudative type patients and total immunoglobulin E and eosinophil (%) were lower in nummular type patients. In prurigo-nodularis type patients, eosinophilic cationic protein and vitamin D deficiency were frequent. Vitamin D deficiency was infrequent in erythrodermic type patients.
Conclusion
Lichenoid/exudative type patients showed classical characteristics of atopic dermatitis, and related to extrinsic type. In nummular type, patients tend to be more intrinsic and less severe. In prurigo-nodularis type, patients would be related to frequent vitamin D deficiency. Erythrodermic type patients showed more extensive atopic dermatitis lesions and less frequent vitamin D deficiency.

Keyword

Atopic dermatitis; Phenotype