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Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji

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

Abstract

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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.

References

  • Kaynaklar 1.Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM,Simpson EL, et al. Guidelines of care for the management of ato-pic dermatitis: section 1. Diagnosis and assessment of atopic der-matitis. J Am Acad Dermatol. 2014;70:338-51. 2.Deckers IA, McLean S, Linssen S, Mommers M, van Schayck CP,Sheikh A. Investigating international time trends in the inciden-ce and prevalence of atopic eczema 1990–2010: a systematic re-view of epidemiological studies. PLoS One 2012;7:e39803. 3.Williams H, Robertson C, Stewart A, Aït-Khaled N, Anabwani G,Anderson R, et al. Worldwide variations in the prevalence ofsymptoms of atopic eczema in the International Study of Asthmaand Allergies in Childhood. J Allergy Clin Immunol 1999;103:125-38. 4.Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR;International Study of Asthma and Allergies in Childhood (ISA-AC) Phase One and Three Study Groups. Is eczema really on theincrease worldwide? J Allergy Clin Immunol 2008 ;121:947-54. 5.Doğruel D, Bingöl G, Altıntaş DU, Yılmaz M, Kendirli SG. Pre-valence of and risk factors for atopic dermatitis: A birth cohortstudy of infants in southeast Turkey. Allergol Immunopathol(Madr). 2016;44:214-20. 6.Akcay A, Tamay Z, Ergin A, Guler N. Prevalence and risk fac-tors of atopic eczema in Turkish adolescents. Pediatr Dermatol.2014;31:319-25. 7.Civelek E, Sahiner UM, Yüksel H, Boz AB, Orhan F, Uner A, etal. Prevalence, burden, and risk factors of atopic eczema in scho-olchildren aged 10-11 years: a national multicenter study. J In-vestig Allergol Clin Immunol. 2011;21:270-77. 8.Elias PM, Hatano Y, Williams ML. Basis for the barrier abnorma-lity in atopic dermatitis: Outside-inside-outside pathogenic mec-hanisms. J Allergy Clin Immunol. 2008 ;121:1337- 43. 9.Bieber T. Atopic dermatitis. N Engl J Med. 2008;358:1483- 94. 10.Oyoshi MK, He R, Kumar L, Yoon J, Geha RS. Cellular and mo-lecular mechanisms in atopic dermatitis. Adv Immunol.2009;102:135-226. 11.Vestergaard C, Bang K, Gesser B, Yoneyama H, Mat- sushima K,Larsen CG. A Th2 chemokine, TARC, produced by keratinocytes mayrecruit CLA+CCR4+lymphocytes into lesional atopic dermatitis skin.J Invest Dermatol. 2000;115:640-46. 12.Oh MH, Oh SY, Lu J, Lou H, Myers AC, Zhu Z, et al. TRPA1-de-pendent pruritus in IL-13-induced chronic atopic dermatitis. J Im-munol. 2013;1:191:5371–82. 13.Cevikbas F, Wang X, Akiyama T, Kempkes C, Savinko T, AntalA, et al. A sensory neuron-expressed IL-31 receptor mediates Thelper cell-dependent itch: involvement of TRPV1 and TRPA1.J Allergy Clin Immunol. 2014;133:448–60. 14.Novak N, Leung DY. Role of barrier dysfunction and immune res-ponse in atopic dermatitis. In: Leung DYM, Sampson HA, GehaR, Szefler SJ, (eds). Pediatric Allergy Principles and Practice.2nd ed. Elsevier. 2010:438-48 15.Suarez-Farinas M, Tintle SJ, Shemer A, Chiricozzi A, NogralesK, Cardinale I, et al. Nonlesional atopic dermatitis skin is cha-racterized by broad terminal differentiation defects and variab-le immune abnormalities. J Allergy Clin Immunol. 2011;127:954–64. 16.Candi E, Schmidt R, Melino G. The cornified envelope: a modelof cell death in the skin. Nat Rev Mol Cell Biol. 2005;6:328-40. 17.Kezic S, Novak N, Jakasa I, Jungersted JM, Simon M, BrandnerJM, et al. Skin barrier in atopic dermatitis. Front Biosci (Land-mark Ed). 2014 1;19:542–56. 18.Kim BE, Leung DY. Epidermal barrier in atopic dermatitis. Al-lergy Asthma Immunol Res. 2012;4:12-6. 19.Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Mo-ustafa M, et al. Epidermal barrier dysfunction in atopic derma-titis. J Invest Dermatol. 2009;129:1892-908. 20.Zhang B, Alysandratos K, Angelidou A, Asadi S, SismanopoulosN, Delivanis DA, et al. Human mast cell degranulation and pre-formed TNF secretion require mitochondrial translocation toexocytosis sites: Relevance to atopic dermatitis. J Allergy ClinImmunol. 2011;127:1522-31. 21.Boguniewicz M, Leung DY. Atopic dermatitis: A disease of al-tered skin barrier and immune dysregulation. Immunol Rev.2011;242:233-46. 22.Cookson W. The immunogenetics of asthma and eczema: a newfocus on the epithelium. Nat Rev Immunol. 2004;4:978-88. 23.Leung DY, New insights into atopic dermatitis: role of skin bar-rier and immune dysregulation. Allergol Int. 2013;62:151-61. 24.van Drongelen V, Haisma EM, Out-Luiting JJ, Nibbering PH, ElGhalbzouri A. Reduced filaggrin expression is accompanied byincreased Staphylococcus aureus colonization of epidermalskin models. Clin Exp Allergy. 2014;44:1515–24. 25.Leung DY, Gao PS, Grigoryev DN, Rafaels NM, Streib JE, Ho-well MD, et al. Human atopic dermatitis complicated by eczemaherpeticum is associated with abnormalities in IFN-γresponse.J Allergy Clin Immunol. 2011;127:965–73. 26.Apfelbacher CJ, Diepgen TL, Schmitt J. Determinants of ecze-ma: population-based cross-sectional study in Germany. Allergy2011;66:206–13. 27.Wadonda-Kabondo N, Sterne JA, Golding J, Kennedy CT, Arc-her CB, Dunnill MG, et al. Association of parental eczema, hay-fever, and asthma with atopic dermatitis in infancy: birth cohortstudy. Arch Dis Childhood 2004;89:917-21. 28.Irvine AD, McLean WH, Leung DY. Filaggrin mutations asso-ciated with skin and allergic diseases. N Engl J Med.2011;365:1315–27. 29.Flohr C, Mann J. New insights into the epidemiology of child-hood atopic dermatitis. Allergy 2014; 69:3–16. 30.Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis re-visited. Curr Probl Dermatol 2011;41:1-34. 31.Katayama I, Kohno Y, Akiyama K, Aihara M, Kondo N, SaekiH, et al. Japanese Guideline for Atopic Dermatitis 2014. Aller-gol Int. 2014;63:377-98. 32.Perkin MR, Strachan DP, Williams HC, Kennedy CT, GoldingJ, Team AS. Natural history of atopic dermatitis and its relati-on- ship to serum total immunoglobulin E in a population-basedbirth cohort study. Pediatr Allergy Immunol. 2004;15:221-29. 33.Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann Bet al, and the Multicenter Allergy Study Group. The natural co-urse of atopic dermatitis from birth to age 7 years and the asso-ciation with asthma. J Allergy Clin Immunol 2004;113:925–31. 34.Peters AS, Kellberger J, Vogelberg C, Dressel H, WindstetterD, Weinmayr G, et al. Prediction of the incidence, recurrence,and persistence of atopic dermatitis in adolescence: a prospec-tive cohort study. J Allergy Clin Immunol 2010;126:590–95. 35.Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis.Acta Dermatol Venerol 1984;92:40-47. 36.Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB. Con-sensus conference on pediatric atopic dermatitis. J Am Acad Der-matol 2003;49:1088-95. 37.Williams HC. Clinical practice. Atopic dermatitis. N Engl J Med.2005;352:2314-24. 38.Benedictis FM, Franceschini F, Hill D, Naspitz C, Simons FE,Wahn U, et al, and the EPAAC Study Group. The allergic sen-sitization in infants with atopic eczema from different countries.Allergy 2009;64:295–303. 39.Wisniewski JA, Agrawal R, Minnicozzi S, Xin W, Patrie J, Hey-mann PW, et al. Sensitization to food and inhalant allergens inrelation to age and wheeze among children with atopic derma-titis. Clin Exp Allergy 2013;43:1160–70. 40.Jahnz-Rozyk K, Targowski T, Paluchowska E, Owczarek W, Kuc-harczyk A. Serum thymus and activation-regulated chemokine, mac-rophage-derived chemokine and eotaxin as markers of severity ofatopic dermatitis. Allergy 2005;60: 685-88. 41.Schmitt J, Langan S, Williams HC. What are the best outcome mea-surements for atopic eczema? A systematic review. J Allergy ClinImmunol 2007;120:1389-98. 42.van der Hulst AE, Klip H, Brand PL. Risk of developing asthmain young children with atopic eczema: a systematic review. J Al-lergy Clin Immunol 2007;120:565–69. 43.Skalka HW, Prchal JT. Effect of corticosteroids on cataract for-mation. Arch Ophthalmol 1980;98:1773–77.44.Camfferman D, Kennedy JD, Gold M, Martin AJ, Lushington K.Eczema and sleep and its relationship to daytime functioning inchildren. Sleep Med Rev 2010;14:359-69. 45.Schmitt J, Buske-Kirschbaum A, Roessner V. Is atopic disease arisk factor for attention-deficit/hyperactivity disorder? A syste-matic review. Allergy 2010;65:1506–24. 46.Yaghmaie P, Koudelka CW, Simpson EL. Mental health comor-bidity in patients with atopic dermatitis. J Allergy Clin Immunol2013;131:428–33. 47.Schmitt J, Schwarz K, Baurecht H, Hotze M, Fölster-Holst R, Rod-ríguez E, et al. Atopic dermatitis is associated with an increasedrisk for rheumatoid arthritis and inflammatory bowel disease, anda decreased risk for type-1 diabetes. J Allergy Clin Immunol2016;137:130-36. 48.Siegfried EC1, Hebert AA2. Diagnosis of Atopic Dermatitis: Mi-mics, Overlaps, and Complications. J Clin Med. 2015;4:884-917. 49.Stephan Weidinger, Natalija Novak. Atopic dermatitis. Lancet2016;387:1109–22.
Year 2017, Volume: 9 Issue: 2, 95 - 102, 15.03.2017

Abstract

References

  • Kaynaklar 1.Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM,Simpson EL, et al. Guidelines of care for the management of ato-pic dermatitis: section 1. Diagnosis and assessment of atopic der-matitis. J Am Acad Dermatol. 2014;70:338-51. 2.Deckers IA, McLean S, Linssen S, Mommers M, van Schayck CP,Sheikh A. Investigating international time trends in the inciden-ce and prevalence of atopic eczema 1990–2010: a systematic re-view of epidemiological studies. PLoS One 2012;7:e39803. 3.Williams H, Robertson C, Stewart A, Aït-Khaled N, Anabwani G,Anderson R, et al. Worldwide variations in the prevalence ofsymptoms of atopic eczema in the International Study of Asthmaand Allergies in Childhood. J Allergy Clin Immunol 1999;103:125-38. 4.Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR;International Study of Asthma and Allergies in Childhood (ISA-AC) Phase One and Three Study Groups. Is eczema really on theincrease worldwide? J Allergy Clin Immunol 2008 ;121:947-54. 5.Doğruel D, Bingöl G, Altıntaş DU, Yılmaz M, Kendirli SG. Pre-valence of and risk factors for atopic dermatitis: A birth cohortstudy of infants in southeast Turkey. Allergol Immunopathol(Madr). 2016;44:214-20. 6.Akcay A, Tamay Z, Ergin A, Guler N. Prevalence and risk fac-tors of atopic eczema in Turkish adolescents. Pediatr Dermatol.2014;31:319-25. 7.Civelek E, Sahiner UM, Yüksel H, Boz AB, Orhan F, Uner A, etal. Prevalence, burden, and risk factors of atopic eczema in scho-olchildren aged 10-11 years: a national multicenter study. J In-vestig Allergol Clin Immunol. 2011;21:270-77. 8.Elias PM, Hatano Y, Williams ML. Basis for the barrier abnorma-lity in atopic dermatitis: Outside-inside-outside pathogenic mec-hanisms. J Allergy Clin Immunol. 2008 ;121:1337- 43. 9.Bieber T. Atopic dermatitis. N Engl J Med. 2008;358:1483- 94. 10.Oyoshi MK, He R, Kumar L, Yoon J, Geha RS. Cellular and mo-lecular mechanisms in atopic dermatitis. Adv Immunol.2009;102:135-226. 11.Vestergaard C, Bang K, Gesser B, Yoneyama H, Mat- sushima K,Larsen CG. A Th2 chemokine, TARC, produced by keratinocytes mayrecruit CLA+CCR4+lymphocytes into lesional atopic dermatitis skin.J Invest Dermatol. 2000;115:640-46. 12.Oh MH, Oh SY, Lu J, Lou H, Myers AC, Zhu Z, et al. TRPA1-de-pendent pruritus in IL-13-induced chronic atopic dermatitis. J Im-munol. 2013;1:191:5371–82. 13.Cevikbas F, Wang X, Akiyama T, Kempkes C, Savinko T, AntalA, et al. A sensory neuron-expressed IL-31 receptor mediates Thelper cell-dependent itch: involvement of TRPV1 and TRPA1.J Allergy Clin Immunol. 2014;133:448–60. 14.Novak N, Leung DY. Role of barrier dysfunction and immune res-ponse in atopic dermatitis. In: Leung DYM, Sampson HA, GehaR, Szefler SJ, (eds). Pediatric Allergy Principles and Practice.2nd ed. Elsevier. 2010:438-48 15.Suarez-Farinas M, Tintle SJ, Shemer A, Chiricozzi A, NogralesK, Cardinale I, et al. Nonlesional atopic dermatitis skin is cha-racterized by broad terminal differentiation defects and variab-le immune abnormalities. J Allergy Clin Immunol. 2011;127:954–64. 16.Candi E, Schmidt R, Melino G. The cornified envelope: a modelof cell death in the skin. Nat Rev Mol Cell Biol. 2005;6:328-40. 17.Kezic S, Novak N, Jakasa I, Jungersted JM, Simon M, BrandnerJM, et al. Skin barrier in atopic dermatitis. Front Biosci (Land-mark Ed). 2014 1;19:542–56. 18.Kim BE, Leung DY. Epidermal barrier in atopic dermatitis. Al-lergy Asthma Immunol Res. 2012;4:12-6. 19.Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Mo-ustafa M, et al. Epidermal barrier dysfunction in atopic derma-titis. J Invest Dermatol. 2009;129:1892-908. 20.Zhang B, Alysandratos K, Angelidou A, Asadi S, SismanopoulosN, Delivanis DA, et al. Human mast cell degranulation and pre-formed TNF secretion require mitochondrial translocation toexocytosis sites: Relevance to atopic dermatitis. J Allergy ClinImmunol. 2011;127:1522-31. 21.Boguniewicz M, Leung DY. Atopic dermatitis: A disease of al-tered skin barrier and immune dysregulation. Immunol Rev.2011;242:233-46. 22.Cookson W. The immunogenetics of asthma and eczema: a newfocus on the epithelium. Nat Rev Immunol. 2004;4:978-88. 23.Leung DY, New insights into atopic dermatitis: role of skin bar-rier and immune dysregulation. Allergol Int. 2013;62:151-61. 24.van Drongelen V, Haisma EM, Out-Luiting JJ, Nibbering PH, ElGhalbzouri A. Reduced filaggrin expression is accompanied byincreased Staphylococcus aureus colonization of epidermalskin models. Clin Exp Allergy. 2014;44:1515–24. 25.Leung DY, Gao PS, Grigoryev DN, Rafaels NM, Streib JE, Ho-well MD, et al. Human atopic dermatitis complicated by eczemaherpeticum is associated with abnormalities in IFN-γresponse.J Allergy Clin Immunol. 2011;127:965–73. 26.Apfelbacher CJ, Diepgen TL, Schmitt J. Determinants of ecze-ma: population-based cross-sectional study in Germany. Allergy2011;66:206–13. 27.Wadonda-Kabondo N, Sterne JA, Golding J, Kennedy CT, Arc-her CB, Dunnill MG, et al. Association of parental eczema, hay-fever, and asthma with atopic dermatitis in infancy: birth cohortstudy. Arch Dis Childhood 2004;89:917-21. 28.Irvine AD, McLean WH, Leung DY. Filaggrin mutations asso-ciated with skin and allergic diseases. N Engl J Med.2011;365:1315–27. 29.Flohr C, Mann J. New insights into the epidemiology of child-hood atopic dermatitis. Allergy 2014; 69:3–16. 30.Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis re-visited. Curr Probl Dermatol 2011;41:1-34. 31.Katayama I, Kohno Y, Akiyama K, Aihara M, Kondo N, SaekiH, et al. Japanese Guideline for Atopic Dermatitis 2014. Aller-gol Int. 2014;63:377-98. 32.Perkin MR, Strachan DP, Williams HC, Kennedy CT, GoldingJ, Team AS. Natural history of atopic dermatitis and its relati-on- ship to serum total immunoglobulin E in a population-basedbirth cohort study. Pediatr Allergy Immunol. 2004;15:221-29. 33.Illi S, von Mutius E, Lau S, Nickel R, Grüber C, Niggemann Bet al, and the Multicenter Allergy Study Group. The natural co-urse of atopic dermatitis from birth to age 7 years and the asso-ciation with asthma. J Allergy Clin Immunol 2004;113:925–31. 34.Peters AS, Kellberger J, Vogelberg C, Dressel H, WindstetterD, Weinmayr G, et al. Prediction of the incidence, recurrence,and persistence of atopic dermatitis in adolescence: a prospec-tive cohort study. J Allergy Clin Immunol 2010;126:590–95. 35.Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis.Acta Dermatol Venerol 1984;92:40-47. 36.Eichenfield LF, Hanifin JM, Luger TA, Stevens SR, Pride HB. Con-sensus conference on pediatric atopic dermatitis. J Am Acad Der-matol 2003;49:1088-95. 37.Williams HC. Clinical practice. Atopic dermatitis. N Engl J Med.2005;352:2314-24. 38.Benedictis FM, Franceschini F, Hill D, Naspitz C, Simons FE,Wahn U, et al, and the EPAAC Study Group. The allergic sen-sitization in infants with atopic eczema from different countries.Allergy 2009;64:295–303. 39.Wisniewski JA, Agrawal R, Minnicozzi S, Xin W, Patrie J, Hey-mann PW, et al. Sensitization to food and inhalant allergens inrelation to age and wheeze among children with atopic derma-titis. Clin Exp Allergy 2013;43:1160–70. 40.Jahnz-Rozyk K, Targowski T, Paluchowska E, Owczarek W, Kuc-harczyk A. Serum thymus and activation-regulated chemokine, mac-rophage-derived chemokine and eotaxin as markers of severity ofatopic dermatitis. Allergy 2005;60: 685-88. 41.Schmitt J, Langan S, Williams HC. What are the best outcome mea-surements for atopic eczema? A systematic review. J Allergy ClinImmunol 2007;120:1389-98. 42.van der Hulst AE, Klip H, Brand PL. Risk of developing asthmain young children with atopic eczema: a systematic review. J Al-lergy Clin Immunol 2007;120:565–69. 43.Skalka HW, Prchal JT. Effect of corticosteroids on cataract for-mation. Arch Ophthalmol 1980;98:1773–77.44.Camfferman D, Kennedy JD, Gold M, Martin AJ, Lushington K.Eczema and sleep and its relationship to daytime functioning inchildren. Sleep Med Rev 2010;14:359-69. 45.Schmitt J, Buske-Kirschbaum A, Roessner V. Is atopic disease arisk factor for attention-deficit/hyperactivity disorder? A syste-matic review. Allergy 2010;65:1506–24. 46.Yaghmaie P, Koudelka CW, Simpson EL. Mental health comor-bidity in patients with atopic dermatitis. J Allergy Clin Immunol2013;131:428–33. 47.Schmitt J, Schwarz K, Baurecht H, Hotze M, Fölster-Holst R, Rod-ríguez E, et al. Atopic dermatitis is associated with an increasedrisk for rheumatoid arthritis and inflammatory bowel disease, anda decreased risk for type-1 diabetes. J Allergy Clin Immunol2016;137:130-36. 48.Siegfried EC1, Hebert AA2. Diagnosis of Atopic Dermatitis: Mi-mics, Overlaps, and Complications. J Clin Med. 2015;4:884-917. 49.Stephan Weidinger, Natalija Novak. Atopic dermatitis. Lancet2016;387:1109–22.
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Primary Language Turkish
Journal Section makale
Authors

Uzm. Dr. Sevgi Sipahi This is me

Publication Date March 15, 2017
Published in Issue Year 2017 Volume: 9 Issue: 2

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APA Sipahi, U. D. S. (2017). Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji. Klinik Tıp Pediatri Dergisi, 9(2), 95-102.
AMA Sipahi UDS. Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji. Pediatri. March 2017;9(2):95-102.
Chicago Sipahi, Uzm. Dr. Sevgi. “Atopik Dermatit: Klinik, Tanı Ve Fizyopatoloji”. Klinik Tıp Pediatri Dergisi 9, no. 2 (March 2017): 95-102.
EndNote Sipahi UDS (March 1, 2017) Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji. Klinik Tıp Pediatri Dergisi 9 2 95–102.
IEEE U. D. S. Sipahi, “Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji”, Pediatri, vol. 9, no. 2, pp. 95–102, 2017.
ISNAD Sipahi, Uzm. Dr. Sevgi. “Atopik Dermatit: Klinik, Tanı Ve Fizyopatoloji”. Klinik Tıp Pediatri Dergisi 9/2 (March 2017), 95-102.
JAMA Sipahi UDS. Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji. Pediatri. 2017;9:95–102.
MLA Sipahi, Uzm. Dr. Sevgi. “Atopik Dermatit: Klinik, Tanı Ve Fizyopatoloji”. Klinik Tıp Pediatri Dergisi, vol. 9, no. 2, 2017, pp. 95-102.
Vancouver Sipahi UDS. Atopik Dermatit: Klinik, Tanı ve Fizyopatoloji. Pediatri. 2017;9(2):95-102.