ADULT-ONSET ATOPIC DERMATITIS: CLINICAL CASE ANALYSIS WITH DIAGNOSTIC AND THERAPEUTIC INSIGHTS

Authors

  • Ivana Dohcheva Karajovanov University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Nebojsha Peshikj University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Vesna Cifrevska Matevska University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Slivija Duma University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Hristina Breshkovska University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Elena Mircheska Arsovska University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Rebeka Vukovska University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Suzana Nikolovska University Clinic for Dermatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Keywords:

Keywords: Adult-onset atopic dermatitis (AOAD), Diagnosis, Differential diagnosis, Clinical severity, Treatment strategies

Abstract

Introduction: Adult-onset atopic dermatitis (AOAD) is a distinct and increasingly recognized condition. This case report presents a patient with severe AOAD, both highlighting diagnostic and therapeutic challenges. Case Report: A 43-year-old male with extensive eczema and elevated IgE levels was treated with systemic corticosteroids, antihistamines, emollients, and phototherapy. Significant clinical improvement was noted. Conclusion: This case illustrates the complex management of AOAD and emphasizes the need for a multidisciplinary and personalized treatment approach.

Objective: This paper discusses a case of AOAD, providing clinical and diagnostic insights while integrating evidence from current literature.

Methods: A 43-year-old male with severe AOAD was evaluated using the Hanifin-Rajka criteria and the SCORAD index for diagnosis and severity assessment. Laboratory, histopathological, and allergological investigations supported the diagnosis. Relevant literature was reviewed to contextualize findings.

Results: The patient presented with extensive xerosis, erythema, and pruritus. Elevated serum IgE and eosinophilia confirmed a heightened atopic state. Management included systemic corticosteroids, antihistamines, emollients, and UVA phototherapy, resulting in symptom improvement. The case highlights the systemic and relapsing nature of AOAD, requiring a multidisciplinary approach.

Conclusion: AOAD differs significantly from COAD in pathogenesis, clinical features, and management. This case contributes to the growing body of literature on AOAD by showcasing its unique clinical features and the complexities associated with managing this under-recognized condition. Personalized, targeted therapies addressing skin barrier dysfunction, immune dysregulation, and systemic inflammation are essential to optimize outcomes.

References

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Published

2025-06-12

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Section

Case Reports