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Atopisches Ekzem im Kindesalter (Neurodermitis)

Zusammenfassung

Das atopische Ekzem bildet zusammen mit der allergischen Rhinokonjunktivitis und dem allergischen Asthma bronchiale die Trias der atopischen Erkrankungen (Rajka, 1990; Ruzicka et al., 1991; Leung et al., 1993). Atopie ist definiert als eine familiär auftretende Überempfindlichkeit von Hautund Schleimhäuten gegen Umweltstoffe, assoziiert mit vermehrter IgE-Produktion und/ oder veränderter unspezifischer Reaktivität (Ring, 1983). Betroffen sind unterschiedliche Organsysteme — die Haut beim atopischen Ekzem, die Schleimhäute von Augen und Nase bei allergischer Rhinokonjunktivitis und das respiratorische Epithel beim allergischen Asthma bronchiale. Während über die pathophysiologischen Zusammenhänge der respiratorischen atopischen Erkrankungen eine Fülle von gesicherten Erkenntnissen vorliegen, bestehen zur Pathogenese des atopischen Ekzems nur mehr oder weniger gesicherte Arbeitshypothesen sehr unterschiedlichen Charakters. Das atopische Ekzem ist gekennzeichnet durch eine Reihe von immunologischen Befunden, die sich nicht in die traditionelle Klassifikation immunologischer Erkrankungen gruppieren lassen. Es bestehen Hinweise für verstärkte zellvermittelte Immunität und Beteiligung von Eosinophilen, gleichzeitig finden sich minimale Defekte der zellvermittelten Immunität vom verzögerten Typ und häufig erhöhte Serum-IgE-Konzentrationen. All dies läßt sich weder mit einer rein zellulären Überempfindlichkeit noch mit einer rein humoralen Überempfindlichkeit vom Soforttyp vereinbaren. Eine Reihe von Untersuchungen der letzten Dekade hat jedoch zur Entwicklung neuer pathogenetischer Konzepte geführt, die einen Großteil der erhobenen Befunde zu integrieren vermögen und uns dem Verständnis dieser rätselhaften Erkrankung etwas näher bringen.

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Authors
  1. Thilo Jakob
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  2. Johannes Ring
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Editors and Affiliations

  1. Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Biedersteiner Str. 29, 80802, München, Germany

    Dietrich Abeck

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Jakob, T., Ring, J. (2002). Aktuelle Konzepte zur Pathogenese. In: Abeck, D., Ring, J. (eds) Atopisches Ekzem im Kindesalter (Neurodermitis). Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57538-9_8

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  • DOI: https://doi.org/10.1007/978-3-642-57538-9_8

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-642-63294-5

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