SELECTED ARTICLES FROM THE RECENT LITERATURE 2008 3/5/08 Intrinsic (atopiform) and extrinsic ("allergic") atopic dermatitis: distinguishing features Summary Phenotypic atopic dermatitis can be associated with IgE mediated reactions and can be "non-atopic." The authors refer to the type with elevated IgE and specific IgE to allergens as atopic, and the type without as "atopiform." These two types of dermatitis have been called extrinsic and intrinsic, mimicking the terminology for asthma, as well. With this background in mind, the investigators performed a study designed to identify clinical and diagnostic features that would distinguish these two varieties of phenotypically indistinguishable atopic dermatitis. They selected patients with a clinical diagnosis of atopic dermatitis without demonstrable allergen-specific IgE, and compared them to a group with detectable allergen-specific IgE. The patients were evaluated for medical history, quality of life, disease severity, and the Hanifin and Rajaka, UK, and Millennium diagnostic criteria. Eight percent of the patients had "atopiform" dermatitis. They demonstrated a female predominance, the absence of associated atopic disease, a later onset of disease, and a milder illness. They had a lesser incidence of a family history of atopy, conjunctivitis, palmar hyperlinearity, keratosis pilaris, pityriasis alba, and hand eczema. On the other hand, the "Dennie-Morgan fold" was positively associated with the atopiform variety. The authors concluded, based upon these findings, that atopiform dermatitis is a distinct entity that can be separated from atopic dermatitis by the characteristics noted above. Reference Elian EA, et al. Clinical differences between atopic and atopiform dermatitis. Journal of American Academy of Dermatology 2008; 58(3):407-414   © Copyright 1997-2008 American Academy of Allergy, Asthma and Immunology All rights reserved