Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji

Year 2017, Volume: 9 Issue: 2, 95 - 102, 15.03.2017

Uzm. Dr. Sevgi Sipahi

Abstract

Öz

Atopik dermatit kronik, kaşıntılı, alevlenme ve düzelmeler ile seyreden inflamatuvar bir cilt hastalığıdır. Prevelansı dünya çapında son yıllarda artış göstermiş ve gelişmiş ülkelerde %10-20’lere kadar yükselmiştir. Atopik dermatitin deri bariyer bozukluğu ile birlikte T hücre disfonksiyonu sonucu geliştiği düşünülmektedir. Epidermal bütünlük ve fonksiyonunda anormallik ile immün sistemin anormal yanıtı patofizyolojinin ana unsurlarını oluşturmaktadırlar. Etiyolojide genetik ve çevresel faktörler birlikte rol alır. En iyi bilinen genetik risk faktörü filagrin gen mutasyonudur; erken başlangıçlı, şiddetli ve persistan hastalık ile ilişkilidir. Atopik dermatit tanısıklinik olarak konulur, temel klinik özellikler kaşıntı ve egzamatöz lezyonlardır. Egzemanın morfolojik özellikleri ve yaşa göre tipik dağılımı tanı koydurucudur. Küçük çocuklarda yüz, boyun ve ekstansör yüzler tutulurken, büyük çocuklarda fleksör bölgeler etkilenir. Hastaların %80’inde total ve spesifik immunoglobulin E değerleri yüksektir, ancak bu değerlerin normal olması hastalığı dışlamaz. Tedaviye dirençli, yanıtsız hastalarda tanı yeniden gözden geçirilmeli ve ayırıcı tanıda metabolik, immunolojik ve nutrisyonel bozukluklar düşünülmelidir.

Keywords

topik dermatit, egzama, epidermal bariyer, immun sistem, filagrin

References

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