Considerations for managing elderly patients with atopic dermatitis

References

• Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345–360. doi: 10.1016/S0140-6736(20)31286-1
   PubMed Web of Science ®Google Scholar
• Saini S, Pansare M. New insights and treatments in atopic dermatitis. Pediatr Clin North Am. 2019;66(5):1021–1033. doi: 10.1016/j.pcl.2019.06.008
   PubMed Web of Science ®Google Scholar
• Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol. 2020;182(1):47–54.
   PubMed Web of Science ®Google Scholar
• Chan LN, Magyari A, Ye M, et al. The epidemiology of atopic dermatitis in older adults: a population-based study in the United Kingdom. PLoS One. 2021 Oct 6;16(10):e0258219. doi: 10.1371/journal.pone.0258219
   PubMed Web of Science ®Google Scholar
• de Lusignan S, Alexander H, Broderick C, et al. The epidemiology of eczema in children and adults in England: a population-based study using primary care data. Clin Exp Allergy. 2021;51(3):471–482. doi: 10.1111/cea.13784
   PubMed Web of Science ®Google Scholar
• Grozdev IS, Van Voorhees AS, Gottlieb AB, et al. Psoriasis in the elderly: from the medical board of the national psoriasis foundation. J Am Acad Dermatol. 2011;65(3):537–545. doi: 10.1016/j.jaad.2010.05.014
   PubMed Web of Science ®Google Scholar
• Patruno C, Potestio L, Napolitano M. Clinical phenotypes of adult atopic dermatitis and related therapies. Curr Opin Allergy Clin Immunol. 2022;22(4):242–249. doi: 10.1097/ACI.0000000000000837
   PubMed Web of Science ®Google Scholar
• Sidbury R, Davis DM, Cohen DE, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327–349. doi: 10.1016/j.jaad.2014.03.030
   PubMed Web of Science ®Google Scholar
• Kulthanan K, Tuchinda P, Nitiyarom R, et al. Clinical practice guidelines for the diagnosis and management of atopic dermatitis. Asian Pac J Allergy Immunol. 2021;39(3):145–155. doi: 10.12932/AP-010221-1050
   PubMed Web of Science ®Google Scholar
• Ali F, Vyas J, Finlay AY. Counting the burden: atopic dermatitis and health-related quality of life. Acta Derm Venereol. 2020;100(12):adv00161.
   PubMed Web of Science ®Google Scholar
• Bieber T, D’Erme AM, Akdis CA, et al. Clinical phenotypes and endophenotypes of atopic dermatitis: where are we, and where should we go? J Allergy Clin Immunol. 2017;139(4):S58–S64. doi: 10.1016/j.jaci.2017.01.008
   PubMed Web of Science ®Google Scholar
• Boireau-Adamezyk E, Baillet-Guffroy A, Stamatas GN. Age-dependent changes in stratum corneum barrier function. Skin Res Technol. 2014;20(4):409–415. doi: 10.1111/srt.12132
   PubMed Web of Science ®Google Scholar
• Luebberding S, Krueger N, Kerscher M. Age-related changes in skin barrier function – quantitative evaluation of 150 female subjects. Int J Cosmet Sci. 2013;35:183–190. doi: 10.1111/ics.12024
   PubMed Web of Science ®Google Scholar
• Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986;15(4):571–585. doi: 10.1016/S0190-9622(86)70208-9
   PubMed Web of Science ®Google Scholar
• Gilchrest BA. Skin aging and photoaging: an overview. J Am Acad Dermatol. 1989;21(3):610–613. doi: 10.1016/S0190-9622(89)70227-9
   PubMed Web of Science ®Google Scholar
• Biniek K, Kaczvinsky J, Matts P, et al. Understanding age induced alterations to the biomechanical barrier function of human stratum corneum. J Dermatol Sci. 2015;80(2):94–101. doi: 10.1016/j.jdermsci.2015.07.016
   PubMed Web of Science ®Google Scholar
• Ramos-e-Silva M, Boza JC, Cestari TF. Effects of age (neonates and elderly) on skin barrier function. Clin Dermatol. 2012;30(3):274–276. doi: 10.1016/j.clindermatol.2011.08.024
   PubMed Web of Science ®Google Scholar
• Rinnerthaler M, Streubel MK, Bischof J, et al. Skin aging, gene expression and calcium. Exp Gerontol. 2015;68:59–65. doi: 10.1016/j.exger.2014.09.015
   PubMed Web of Science ®Google Scholar
• Zouboulis CC, Adjaye J, Akamatsu H, et al. Human skin stem cells and the ageing process. Exp Gerontol. 2008;43(11):986–997. doi: 10.1016/j.exger.2008.09.001
   PubMed Web of Science ®Google Scholar
• Quan T, Fisher GJ. Role of age-associated alterations of the dermal extracellular matrix microenvironment in human skin aging: a mini-review. Gerontology. 2015;61(5):427–434. doi: 10.1159/000371708
   PubMed Web of Science ®Google Scholar
• Candi E, Schmidt R, Melino G. The cornified envelope: a model of cell death in the skin. Nat Rev Mol Cell Biol. 2005;6(4):328–340. doi: 10.1038/nrm1619
   PubMed Web of Science ®Google Scholar
• Rinnerthaler M, Duschl J, Steinbacher P, et al. Age- related changes in the composition of the cornified envelope in human skin. Exp Dermatol. 2013;22(5):329–335. doi: 10.1111/exd.12135
   PubMed Web of Science ®Google Scholar
• Niessen CM. Tight junctions/adherens junctions: basic structure and function. J Invest Dermatol. 2007;127(11):2525–2532. doi: 10.1038/sj.jid.5700865
   PubMed Web of Science ®Google Scholar
• Weidinger S, Beck LA, Bieber T, et al. Atopic dermatitis. Nat Rev Dis Primers. 2018;4(1):1. doi: 10.1038/s41572-018-0001-z
   PubMed Web of Science ®Google Scholar
• Jin SP, Han SB, Kim YK, et al. Changes in tight junction protein expression in intrinsic aging and photoaging in human skin in vivo. J Dermatol Sci. 2016;84(1):99–101. doi: 10.1016/j.jdermsci.2016.07.002
   PubMed Web of Science ®Google Scholar
• De Benedetto A, Rafaels NM, McGirt LY, et al. Tight junction defects in patients with atopic dermatitis. J Allergy Clin Immunol. 2011;127(3):773–786.e7. doi: 10.1016/j.jaci.2010.10.018
   PubMed Web of Science ®Google Scholar
• Sugawara T, Iwamoto N, Akashi M, et al. Tight junction dysfunction in the stratum granulosum leads to aberrant stratum corneum barrier function in claudin-1- deficient mice. J Dermatol Sci. 2013;70(1):12–18. doi: 10.1016/j.jdermsci.2013.01.002
   PubMed Web of Science ®Google Scholar
• Kottner J, Lichterfeld A, Blume-Peytavi U. Transepidermal water loss in young and aged healthy humans: a systematic review and meta-analysis. Arch Dermatol Res. 2013;305(4):315–323. doi: 10.1007/s00403-012-1313-6
   PubMed Web of Science ®Google Scholar
• Roskos KV, Guy RH. Assessment of skin barrier function using transepidermal water loss: effect of age. Pharm Res. 1989;6(11):949–953. doi: 10.1023/A:1015941412620
   PubMed Web of Science ®Google Scholar
• Cork MJ, Robinson DA, Vasilopoulos Y, et al. New perspectives on epidermal barrier dysfunction in atopic dermatitis: gene–environment interactions. J Allergy Clin Immunol. 2006;118(1):3–21; quiz 22–3. doi: 10.1016/j.jaci.2006.04.042
   Web of Science ®Google Scholar
• Ghadially R, Brown BE, Sequeira-Martin SM, et al. The aged epidermal permeability barrier. Structural, functional, and lipid biochemical abnormalities in humans and a senescent murine model. J Clin Invest. 1995;95(5):2281–2290. doi: 10.1172/JCI117919
   PubMed Web of Science ®Google Scholar
• Shaw AC, Goldstein DR, Montgomery RR. Age-dependent dysregulation of innate immunity. Nat Rev Immunol. 2013;13(12):875–887. doi: 10.1038/nri3547
   PubMed Web of Science ®Google Scholar
• Licastro F, Candore G, Lio D, et al. Innate immunity and inflammation in ageing: a key for understanding age-related diseases. Immun Ageing. 2005;2(1):8. doi: 10.1186/1742-4933-2-8
   PubMedGoogle Scholar
• Kollmann TR, Levy O, Montgomery RR, et al. Innate immune function by Toll-like receptors: distinct responses in newborns and the elderly. Immunity. 2012;37(5):771–783. doi: 10.1016/j.immuni.2012.10.014
   PubMed Web of Science ®Google Scholar
• Montgomery RR, Shaw AC. Paradoxical changes in innate immunity in aging: recent progress and new directions. J Leukocyte Biol. 2015;98(6):937–943. doi: 10.1189/jlb.5MR0315-104R
   PubMed Web of Science ®Google Scholar
• Hakim FT, Gress RE. Immunosenescence: deficits in adaptive immunity in the elderly. Tissue Antigens. 2007;70(3):179–189. doi: 10.1111/j.1399-0039.2007.00891.x
   PubMedGoogle Scholar
• Brunner PM, Guttman-Yassky E, Leung DY. The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies. J Allergy Clin Immunol. 2017;139(4):S65–S76. doi: 10.1016/j.jaci.2017.01.011
   PubMed Web of Science ®Google Scholar
• Boren E, Gershwin ME. Inflamm-aging: autoimmunity, and the immune-risk phenotype. Autoimmun Rev. 2004;3(5):401–406. doi: 10.1016/j.autrev.2004.03.004
   PubMed Web of Science ®Google Scholar
• Nobbe S, Dziunycz P, Mühleisen B, et al. IL-31 expression by inflammatory cells is preferentially elevated in atopic dermatitis. Acta Derm Venereol. 2012;92(1):24–28. doi: 10.2340/00015555-1191
   PubMed Web of Science ®Google Scholar
• Raap U, Weissmantel S, Gehring M, et al. IL-31 significantly correlates with disease activity and Th2 cytokine levels in children with atopic dermatitis. Pediatr Allergy Immunol. 2012;23(3):285–288. doi: 10.1111/j.1399-3038.2011.01241.x
   PubMed Web of Science ®Google Scholar
• Szegedi K, Kremer AE, Kezic S, et al. Increased frequencies of IL-31-producing T cells are found in chronic atopic dermatitis skin. Exp Dermatol. 2012;21(6):431–436. doi: 10.1111/j.1600-0625.2012.01487.x
   PubMed Web of Science ®Google Scholar
• Ginaldi L, De Martinis M, Ciccarelli F, et al. Increased levels of interleukin 31 (IL-31) in osteoporosis. BMC Immunol. 2015;16(1):60. doi: 10.1186/s12865-015-0125-9
   PubMed Web of Science ®Google Scholar
• Sonkoly E, Muller A, Lauerma AI, et al. IL-31: a new link between T cells and pruritus in atopic skin inflammation. J Allergy Clin Immunol. 2006;117(2):411–417. doi: 10.1016/j.jaci.2005.10.033
   PubMed Web of Science ®Google Scholar
• Homey B, Steinhoff M, Ruzicka T, et al. Cytokines and chemokines orchestrate atopic skin inflammation. J Allergy Clin Immunol. 2006;118(1):178–189. doi: 10.1016/j.jaci.2006.03.047
   PubMed Web of Science ®Google Scholar
• Jin M, Yoon J. From bench to clinic: the potential of therapeutic targeting of the IL-22 signaling pathway in atopic dermatitis. Immune Netw. 2018;18(6):e42. doi: 10.4110/in.2018.18.e42
   PubMed Web of Science ®Google Scholar
• Yoon J, Leyva-Castillo JM, Wang G, et al. IL-23 induced in keratinocytes by endogenous TLR4 ligands polarizes dendritic cells to drive IL-22 responses to skin immunization. J Exp Med. 2016;213(10):2147–2166. doi: 10.1084/jem.20150376
   PubMed Web of Science ®Google Scholar
• Gittler JK, Shemer A, Suárez-Fariñas M, et al. Progressive activation of T(H)2/T(H)22 cytokines and selective epidermal proteins characterizes acute and chronic atopic dermatitis. J Allergy Clin Immunol. 2012;130(6):1344–1354. doi: 10.1016/j.jaci.2012.07.012
   PubMed Web of Science ®Google Scholar
• Teraki Y, Sakurai A, Izaki S. IL-13/IL-22–coproducing T cells, a novel subset, are increased in atopic dermatitis. J Allergy Clin Immunol. 2013;132(4):971–974. doi: 10.1016/j.jaci.2013.07.029
   PubMed Web of Science ®Google Scholar
• Lou H, Lu J, Choi EB, et al. Expression of IL-22 in the skin causes Th2-biased immunity, epidermal barrier dysfunction, and pruritus via stimulating epithelial Th2 cytokines and the GRP pathway. J Immunol. 2017;198(7):2543–2555. doi: 10.4049/jimmunol.1600126
   PubMed Web of Science ®Google Scholar
• Weksler ME, Szabo P. The effect of age on the B-cell repertoire. J Clin Immunol. 2000 Jul;20(4):240–249. doi: 10.1023/A:1006659401385
   PubMed Web of Science ®Google Scholar
• Mediaty A, Neuber K. Total and specific serum IgE decreases with age in patients with allergic rhinitis, asthma and insect allergy but not in patients with atopic dermatitis. Immun Ageing. 2005;2(1):9. doi: 10.1186/1742-4933-2-9
   PubMedGoogle Scholar
• Oppel T, Schuller E, Gunther S, et al. Phenotyping of epidermal dendritic cells allows the differentiation between extrinsic and intrinsic forms of atopic dermatitis. Br J Dermatol. 2000;143(6):1193–1198. doi: 10.1046/j.1365-2133.2000.03887.x
   PubMed Web of Science ®Google Scholar
• Bozek A, Fisher A, Filipowska B, et al. Clinical features and immunological markers of atopic dermatitis in elderly patients. Int Arch Allergy Immunol. 2012;157(4):372–378. doi: 10.1159/000329150
   PubMed Web of Science ®Google Scholar
• Novak N, Kruse S, Kraft S, et al. Dichotomic nature of atopic dermatitis reflected by combined analysis of monocyte immunophenotyping and single nucleotide polymorphisms of the interleukin-4/interleukin-13 receptor gene: the dichotomy of extrinsic and intrinsic atopic dermatitis. J Invest Dermatol. 2002;119(4):870–875. doi: 10.1046/j.1523-1747.2002.00191.x
   PubMed Web of Science ®Google Scholar
• Reich A, Ständer S, Szepietowski JC. Pruritus in the elderly. Clin Dermatol. 2011;29(1):15–23. doi: 10.1016/j.clindermatol.2010.07.002
   PubMed Web of Science ®Google Scholar
• Mansouri Y, Guttman-Yassky E. Immune pathways in atopic dermatitis, and definition of biomarkers through broad and targeted therapeutics. J Clin Med. 2015;4(5):858–873.
   PubMed Web of Science ®Google Scholar
• Suárez-Fariñas M, Dhingra N, Gittler J, et al. Intrinsic atopic dermatitis shows similar TH2 and higher TH17 immune activation compared with extrinsic atopic dermatitis. J Allergy Clin Immunol. 2013;132(2):361–370. doi: 10.1016/j.jaci.2013.04.046
   PubMed Web of Science ®Google Scholar
• Malajian D, Guttman-Yassky E. New pathogenic and therapeutic paradigms in atopic dermatitis. Cytokine. 2015;73(2):311–318. doi: 10.1016/j.cyto.2014.11.023
   PubMed Web of Science ®Google Scholar
• Czarnowicki T, He H, Canter T, et al. Evolution of pathologic T- cell subsets in patients with atopic dermatitis from infancy to adulthood. J Allergy Clin Immunol. 2020;145(1):215–228. doi: 10.1016/j.jaci.2019.09.031
   PubMed Web of Science ®Google Scholar
• Guttman-Yassky E, Waldman A, Ahluwalia J, et al. Atopic dermatitis: pathogenesis. Semin Cutan Med Surg. 2017;36(3):100–103. doi: 10.12788/j.sder.2017.036
   PubMed Web of Science ®Google Scholar
• Wollenberg A, Kraft S, Hanau D, et al. Immunomorphological and ultrastructural characterization of langerhans cells and a novel, inflammatory dendritic epidermal cell (IDEC) population in lesional skin of atopic eczema. J Investig Dermatol. 1996;106(3):446–453. doi: 10.1111/1523-1747.ep12343596
   PubMed Web of Science ®Google Scholar
• Otsuka A, Kabashima K. Mast cells and basophils in cutaneous immune responses. Allergy. 2015;70(2):131–140. doi: 10.1111/all.12526
   PubMed Web of Science ®Google Scholar
• Mashiko S, Bouguermouh S, Rubio M, et al. Human mast cells are major IL-22 producers in patients with psoriasis and atopic dermatitis. J Allergy Clin Immunol. 2015;136(2):351–359.e1. doi: 10.1016/j.jaci.2015.01.033
   PubMed Web of Science ®Google Scholar
• Kiehl P, Falkenberg K, Vogelbruch M, et al. Tissue eosinophilia in acute and chronic atopic dermatitis: a morphometric approach using quantitative image analysis of immunostaining. Br J Dermatol. 2001;145(5):720–729. doi: 10.1046/j.1365-2133.2001.04456.x
   PubMed Web of Science ®Google Scholar
• Schmelz M, Schmidt R, Bickel A, et al. Specific C- receptors for itch in human skin. J Neurosci. 1997;17(20):8003–8008. doi: 10.1523/JNEUROSCI.17-20-08003.1997
   PubMed Web of Science ®Google Scholar
• Nakatsuji T, Chen TH, Two AM, et al. Staphylococcus aureus exploits epidermal barrier defects in atopic dermatitis to trigger cytokine expression. J Invest Dermatol. 2016;136(11):2192–2200. doi: 10.1016/j.jid.2016.05.127
   PubMed Web of Science ®Google Scholar
• Stefanovic N, Flohr C, Irvine AD. The exposome in atopic dermatitis. Allergy. 2020 Jan;75(1):63–74. doi: 10.1111/all.13946
   PubMed Web of Science ®Google Scholar
• Grafanaki K, Bania A, Kaliatsi EG, et al. The imprint of exposome on the development of atopic dermatitis across the lifespan: a narrative review. J Clin Med. 2023;12(6):2180. doi: 10.3390/jcm12062180
   PubMed Web of Science ®Google Scholar
• Stark L, Olofsson M, L€ofgren S, et al. Prevalence and molecular epidemiology of Staphylococcus aureus in Swedish nursing homes – as revealed in the SHADES study. Epidemiol Infect. 2014;142(6):1310–1316. doi: 10.1017/S0950268813002033
   PubMed Web of Science ®Google Scholar
• den Heijer CDJ, van Bijnen EME, Paget WJ, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin resistant S. aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis. 2013;13(5):409–415. doi: 10.1016/S1473-3099(13)70036-7
   PubMed Web of Science ®Google Scholar
• Zheng T, Yu J, Oh MH, et al. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. Allergy Asthma Immunol Res. 2011;3(2):67–73. doi: 10.4168/aair.2011.3.2.67
   PubMed Web of Science ®Google Scholar
• Whohrl S, Hemmer W, Focke M, et al. Patch testing in children, adults, and the elderly: influence of age and sex on sensitization patterns. Pediatr Dermatol. 2003;20(2):119–123. doi: 10.1046/j.1525-1470.2003.20204.x
   PubMed Web of Science ®Google Scholar
• Wantke F, Hemmer W, Jarisch R, et al. Patch test reactions in children, adults and the elderly. A comparative study in patients with suspected allergic contact dermatitis. Contact Dermatitis. 1996;34(5):316–319. doi: 10.1111/j.1600-0536.1996.tb02214.x
   PubMed Web of Science ®Google Scholar
• Arcanjo LC. Reactivity of the contact tests (patch test) in elderly patients compared to non-elderly at the allergy clinic of the Policlínica geral do Rio de Janeiro. World Allergy Organ J. 2015;8(Suppl. 1):A202. doi: 10.1186/1939-4551-8-S1-A202
   Google Scholar
• Stefansson K, Brattsand M, Roosterman D, et al. Activation of proteinase activated receptor-2 by human kallikrein-related peptidases. J Investig Dermatol. 2008;128(1):18–25. doi: 10.1038/sj.jid.5700965
   PubMed Web of Science ®Google Scholar
• Steinhoff M, Neisius U, Ikoma A, et al. Proteinase-activated receptor-2 mediates itch: a novel pathway for pruritus in human skin. J Neurosci. 2003;23(15):6176–6180. doi: 10.1523/JNEUROSCI.23-15-06176.2003
   PubMed Web of Science ®Google Scholar
• Buddenkotte J, Stroh C, Engels IH, et al. Agonists of proteinase-activated receptor-2 stimulate upregulation of intercellular cell adhesion molecule-1 in primary human keratinocytes via activation of NF-kappa B. J Investig Dermatol. 2005;124(1):38–45. doi: 10.1111/j.0022-202X.2004.23539.x
   PubMed Web of Science ®Google Scholar
• Lee SE, Jeong SK, Lee SH. Protease and protease-activated receptor-2 signaling in the pathogenesis of atopic dermatitis. Yonsei Med J. 2010;51(6):808–822. doi: 10.3349/ymj.2010.51.6.808
   PubMed Web of Science ®Google Scholar
• Cattaruzza F, Amadesi S, Carlsson JF, et al. Serine proteases and protease-activated receptor 2 mediate the proinflammatory and analgesic actions of diverse stimulants. Br J Pharmacol. 2014;171(16):3814–3826. doi: 10.1111/bph.12738
   PubMed Web of Science ®Google Scholar
• Kato T, Takai T, Fujimura T, et al. Mite serine protease activates protease-activated receptor-2 and induces cytokine release in human keratinocytes. Allergy. 2009;64(9):1366–1374. doi: 10.1111/j.1398-9995.2009.02023.x
   PubMed Web of Science ®Google Scholar
• Tokura Y. Extrinsic and intrinsic types of atopic dermatitis. J Dermatol Sci. 2010;58(1):1–7. doi: 10.1016/j.jdermsci.2010.02.008
   PubMed Web of Science ®Google Scholar
• Tanei R. Atopic dermatitis in the elderly. IADT. 2009;8(5):398–404. doi: 10.2174/1871528110908050398
   Google Scholar
• Tanei R. Senile atopic dermatitis. In: Katayama I, Murota H, Satoh T, editors. Evolution of atopic dermatitis in the 21st century. Singapore: Springer; 2018. p. 229–248.
   Google Scholar
• Tanei R, Hasegawa Y, Sawabe M. Abundant immunoglobulin E-positive cells in skin lesions support an allergic etiology of atopic dermatitis in the elderly. J Eur Acad Dermatol Venereol. 2013;27(8):952–960. doi: 10.1111/j.1468-3083.2012.04612.x
   PubMed Web of Science ®Google Scholar
• Nishioka K. Atopic eczema of adult type in Japan. Aust J Dermatol. 1996;37(Suppl):S7–S9. doi: 10.1111/j.1440-0960.1996.tb01088.x
   Google Scholar
• Garmhausen D, Hagemann T, Bieber T, et al. Characterization of different courses of atopic dermatitis in adolescent and adult patients. Allergy. 2013;68(4):498–506. doi: 10.1111/all.12112
   PubMed Web of Science ®Google Scholar
• Tanei R, Katsuoka K. Clinical analyses of atopic dermatitis in the aged. J Dermatol. 2008;35(9):562–569. doi: 10.1111/j.1346-8138.2008.00524.x
   PubMed Web of Science ®Google Scholar
• Aoki T, Fukuzumi T, Adachi J, et al. Re-evaluation of skin lesion distribution in atopic dermatitis. Analysis of cases 0 to 9 years of age. Acta Derm Venereol Suppl (Stockh). 1992;176:19–23.
   PubMedGoogle Scholar
• Sulzberger MB, Goodman J. The relative importance of specific skin hypersensitivity in adult atopic dermatitis. JAMA. 1936;106(12):1000–1003. doi: 10.1001/jama.1936.02770120032010
   Google Scholar
• Silverberg JI, Margolis DJ, Boguniewicz M, et al. Distribution of atopic dermatitis lesions in United States adults. J Eur Acad Dermatol Venereol. 2019;33(7):1341–1348. doi: 10.1111/jdv.15574
   PubMed Web of Science ®Google Scholar
• Napolitano M, Fabbrocini G, Scalvenzi M, et al. Efficacy and safety of dupilumab in atopic dermatitis in elderly patients: a retrospective study. Clin Exp Dermatol. 2020 Oct;45(7):888–890.
   PubMed Web of Science ®Google Scholar
• Scichilone N, Calari A, Augugliaro G, et al. The impact of age on prevalence of positive skin prick tests and specific IgE tests. Respir med. 2011;105(5):651–658. doi: 10.1016/j.rmed.2010.12.014
   PubMed Web of Science ®Google Scholar
• Camacho FM, Garciía-Hernandez MJ, Muñoz-Prez MA, et al. Ofuji papuloerythroderma in elderly woman with atopic erythroderma. J Eur Acad Dermatol Venereol. 2001;15(3):264–266. doi: 10.1046/j.1468-3083.2001.02532.x
   PubMed Web of Science ®Google Scholar
• Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy. 2018 Jun;73(6):1284–1293.
   PubMed Web of Science ®Google Scholar
• Silverberg JI, Gelfand JM, Margolis DJ, et al. Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults. Ann Allergy Asthma Immunol. 2018;121(5):604–612.e3. doi: 10.1016/j.anai.2018.07.042
   PubMed Web of Science ®Google Scholar
• Shaheen MS, Silverberg JI. Atopic dermatitis is associated with osteoporosis and osteopenia in older adults. J Am Acad Dermatol. 2019;80(2):550–551. doi: 10.1016/j.jaad.2018.05.026
   PubMed Web of Science ®Google Scholar
• He H, Li R, Choi S, et al. Increased cardiovascular and atherosclerosis markers in blood of older patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2020;124(1):70–78. doi: 10.1016/j.anai.2019.10.013
   PubMed Web of Science ®Google Scholar
• Brunner PM, Silverberg JI, Guttman-Yassky E, et al. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Investig Dermatol. 2017;137(1):18–25. doi: 10.1016/j.jid.2016.08.022
   PubMed Web of Science ®Google Scholar
• Brummer GC, Wang LT, Sontheimer RD. A possible role for dupilumab (dupixent) in the management of idiopathic chronic eczematous eruption of aging. Dermatol Online J. 2018;24(2):3. doi: 10.5070/D3242038109
   Google Scholar
• Asai T, Horiuchi Y. Senile erythroderma with serum hyper IgE. Int J Dermatol. 1989;28(4):255–258. doi: 10.1111/j.1365-4362.1989.tb04815.x
   PubMed Web of Science ®Google Scholar
• Nakano-Tahara M, Terao M, Nishioka M, et al. T helper 2 polarization in senile erythroderma with elevated levels of TARC and IgE. Dermatology. 2015;230(1):62–69. doi: 10.1159/000366502
   PubMed Web of Science ®Google Scholar
• Katoh N, Ohya Y, Ikeda M, et al. Clinical practice guidelines for the management of atopic dermatitis 2018. J Dermatol. 2019;46(12):1053–1101. doi: 10.1111/1346-8138.15090
   PubMed Web of Science ®Google Scholar
• Katayama I, Aihara M, Ohya Y, et al. Japanese guidelines for atopic dermatitis 2017. Allergo Int. 2017;66(2):230–247. doi: 10.1016/j.alit.2016.12.003
   PubMed Web of Science ®Google Scholar
• Eichenfield LF, Ahluwalia J, Waldman A, et al. Current guidelines for the evaluation and management of atopic dermatitis: a comparison of the joint task force practice parameter and American academy of dermatology guidelines. J Allergy Clin Immunol. 2017;139(4S):S49–S57. doi: 10.1016/j.jaci.2017.01.009
   PubMed Web of Science ®Google Scholar
• Wollenberg A, Barbarot S, Bieber T, et al. Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657–682. doi: 10.1111/jdv.14891
   PubMed Web of Science ®Google Scholar
• Wollenberg A, Barbarot S, Bieber T, et al. Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol. 2018;32(6):850–878. doi: 10.1111/jdv.14888
   PubMed Web of Science ®Google Scholar
• Irawan Y, Rihatmadja R, Legiawait L, et al. Atopic dermatitis in the elderly. J Gen Proced Dermatol Venereol Indones. 2016;1(2):54–61. doi: 10.19100/jdvi.v1i2.32
   Google Scholar
• Suzuki T, Uchino T, Miyazaki Y, et al. The effect of storage time on the release profile of dexamethasone dipropionate from admixtures of steroid and heparinoid ointments. Pharmazie. 2014;69(2):104–108.
   PubMed Web of Science ®Google Scholar
• Tanei R, Oda A, Hasegawa Y. Narrow-band ultraviolet B is a useful adjunctive treatment for atopic dermatitis in older adults: case reports. Dermatol Clin Res. 2016;2(3):112–117.
   Google Scholar
• Tintle S, Shemer A, Suárez-Fariñas M, et al. Reversal of atopic dermatitis with narrow-band UVB phototherapy and biomarkers for therapeutic response. J Allergy Clin Immunol. 2011;128(3):583–593.e4. doi: 10.1016/j.jaci.2011.05.042
   PubMed Web of Science ®Google Scholar
• Beck LA, Thaçi D, Hamilton JD, et al. Dupilumab treatment in adults with moderate-to-severe atopic dermatitis. N Engl J Med. 2014;371(2):130–139. doi: 10.1056/NEJMoa1314768
   PubMed Web of Science ®Google Scholar
• Guttman-Yassky E, Bissonnette R, Ungar B, et al. Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol. 2019;143(1):155–172. doi: 10.1016/j.jaci.2018.08.022
   PubMed Web of Science ®Google Scholar
• Blauvelt A, de Bruin-Weller M, Gooderham M, et al. Longterm management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebocontrolled, phase 3 trial. Lancet. 2017;389(10086):2287–2303. doi: 10.1016/S0140-6736(17)31191-1
   PubMed Web of Science ®Google Scholar
• Napolitano M, Maffei M, Patruno C, et al. Dupilumab effectiveness for the treatment of patients with concomitant atopic dermatitis and chronic rhinosinusitis with nasal polyposis. Dermatol Ther. 2021;34(6):e15120. doi: 10.1111/dth.15120
   PubMed Web of Science ®Google Scholar
• Napolitano M, Fabbrocini G, Potestio L, et al. A 24-weeks real-world experience of dupilumab in adolescents with moderate-to-severe atopic dermatitis. Dermatol Ther. 2022;35(8):e15588. doi: 10.1111/dth.15588
   PubMed Web of Science ®Google Scholar
• Worm M, Simpson EL, Thaçi D, et al. Efficacy and safety of multiple dupilumab dose regimens after initial successful treatment in patients with atopic dermatitis: a randomized clinical trial. JAMA Dermatol. 2020;156(2):131–143. doi: 10.1001/jamadermatol.2019.3617
   PubMed Web of Science ®Google Scholar
• Armario-Hita JC, Pereyra-Rodriguez J, Silvestre JF, et al. Treatment of moderate-to-severe atopic dermatitis with dupilumab in real clinical practice: a multicentre, retrospective case series. Br J Dermatol. 2019;181(5):1072–1074. doi: 10.1111/bjd.18041
   PubMed Web of Science ®Google Scholar
• Ruiz-Villaverde R, Dominguez-Cruz J, Armario-Hita JC, et al. Fifty-two week follow-up safety and effectiveness results of dupilumab treatment of moderate-to-severe atopic dermatitis from a retrospective, multicentric series. Dermatol Ther. 2019;32:e12931. doi: 10.1111/dth.12931
   PubMed Web of Science ®Google Scholar
• Jo CE, Georgakopoulos JR, Ladda M, et al. Evaluation of long term efficacy, safety, and reasons for discontinuation of dupilumab for moderate to severe atopic dermatitis in clinical practice: a retrospective cohort study. J Am Acad Dermatol. 2020;82(6):1530–1532. doi: 10.1016/j.jaad.2020.02.029
   PubMed Web of Science ®Google Scholar
• Fargnoli MC, Esposito M, Ferrucci S, et al. Real-life experience on effectiveness and safety of dupilumab in adult patients with moderate-to-severe atopic dermatitis. J Dermatol Treat. 2019;28:1–7.
   Google Scholar
• Fargnoli MC, Esposito M, Ferrucci S, et al. A 48-week update of a multicentre real-life experience of dupilumab in adult patients with moderate-to-severe atopic dermatitis. J DermatolTreat. 2020;3:1–4.
   Google Scholar
• Nettis E, Fabbrocini G, Ortoncelli M, et al. Long- term effectiveness of dupilumab up to 52 weeks in atopic dermatitis in 253 adult patients. Br J Dermatol. 2020;184(3):561–563. (epub ahead of print). doi: 10.1111/bjd.19577
   PubMed Web of Science ®Google Scholar
• Napolitano C, Patruno M, Argenziano G, et al. Dermoscopic assessment of long-term systemic therapy with dupilumab in adult atopic dermatitis. J Eur Acad Dermatol Venereol. 2020;34(11):e701–e703. doi: 10.1111/jdv.16409
   PubMed Web of Science ®Google Scholar
• de Bruin-Weller M, Thaçi D, Smith CH, et al. Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin a or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFÉ). Br J Dermatol. 2018;178:1083–1101. doi: 10.1111/bjd.16156
   PubMed Web of Science ®Google Scholar
• Castro M, Corren J, Pavord ID, et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018;378(26):2486–2496. doi: 10.1056/NEJMoa1804092
   PubMed Web of Science ®Google Scholar
• Merola JF, Butler DC, Mark T, et al. Safety and efficacy of tralokinumab in older adults with moderate-to-severe atopic dermatitis: a secondary analysis. JAMA Dermatol. 2023;159(10):e232626. doi: 10.1001/jamadermatol.2023.2626
   Web of Science ®Google Scholar
• Napolitano M, Potestio L, Menna L, et al. Tralokinumab in elderly atopic. Ital J Dermatol Venerol. 2023;158(5):419–420. doi: 10.23736/S2784-8671.23.07446-7
   PubMedGoogle Scholar
• Teng Y, Zhong H, Yang X, et al. Current and emerging therapies for atopic dermatitis in the elderly. Clin Interv Aging. 2023 Oct 2;18:1641–1652. doi: 10.2147/CIA.S426044
   PubMed Web of Science ®Google Scholar
• [Accessed 2023 Oct 17]. https://www.ema.europa.eu/en/medicines/human/referrals/janus-kinase-inhibitors-jaki#:~:text=These%20medicines%20should%20be%20used,past%20and%20those%20at%20increased
   Google Scholar
• Sreekantaswamy SA, Tully J, Edelman LS, et al. The underrepresentation of older adults in clinical trials of Janus kinase inhibitors in the treatment of atopic dermatitis. J Am Acad Dermatol. 2022;87(5):1174–1176. doi: 10.1016/j.jaad.2022.02.051
   PubMed Web of Science ®Google Scholar
• Piscazzi F, Gargiulo L, Ibba L, et al. Upadacitinib for the treatment of atopic dermatitis in the elderly: an Italian case series of seven patients. J Dermatol Treat. 2023;34(1):2245510. doi: 10.1080/09546634.2023.2245510
   PubMed Web of Science ®Google Scholar