Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword Georg Rajka
- Preface
- Part I The nature of the problem
- 1 What is atopic dermatitis and how should it be defined in epidemiological studies?
- 2 The pathophysiology and clinical features of atopic dermatitis
- 3 The natural history of atopic dermatitis
- 4 Occupational aspects of atopic dermatitis
- Part II Descriptive studies which indicate the size of the problem
- Part III Analytical studies which point to causes of atopic dermatitis
- Part IV Intervention studies
- Part V Lessons from other fields of research
- Part VI Conclusions
- Additional information
- Index
- Plate section
1 - What is atopic dermatitis and how should it be defined in epidemiological studies?
from Part I - The nature of the problem
Published online by Cambridge University Press: 17 August 2009
- Frontmatter
- Contents
- List of contributors
- Foreword Georg Rajka
- Preface
- Part I The nature of the problem
- 1 What is atopic dermatitis and how should it be defined in epidemiological studies?
- 2 The pathophysiology and clinical features of atopic dermatitis
- 3 The natural history of atopic dermatitis
- 4 Occupational aspects of atopic dermatitis
- Part II Descriptive studies which indicate the size of the problem
- Part III Analytical studies which point to causes of atopic dermatitis
- Part IV Intervention studies
- Part V Lessons from other fields of research
- Part VI Conclusions
- Additional information
- Index
- Plate section
Summary
Developing reliable diagnostic criteria may be as tedious as filling in muddy holes with concrete but both provide the foundation on which all else depends
(Professor R.E. Kendell, 1975)What is atopic dermatitis?
A distinct ‘entity’ or a continuum?
A particular problem hindering understanding of disease classification in dermatology today is ‘binary thought disorder’. Binary thought disorder is a state whereby individuals are unable to appreciate that most biological phenomena do not fit neatly into all-or-nothing ‘either/or’ categories. Ever since Pickering shook the medical world by daring to suggest that essential hypertension, a major cause of death, was a graded characteristic which shaded insensibly into normality (Oldham et al., 1960), many physicians still have difficulties in viewing diseases as a quantitative or multidimensional process. Yet in a population setting, even with diseases like hepatitis, which might at first appear to conform well to a dichotomous disease definition, one sees a gradation of sickness ranging from those who are apparently healthy (many of whom will have sub-clinical infection), those who have mild gastrointestinal symptoms (some of whom are not infected), some who are moderately ill and some who are moribund or dead. Similarly, in atopic dermatitis (AD) one sees some children with normal skin (but with high IgE and positive skin prick tests to allergens), children with mucosal atopy and dry skin only, some with one episode of itching and erythema in just one flexure, and others with classical persistent flexural disease.
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- Information
- Atopic DermatitisThe Epidemiology, Causes and Prevention of Atopic Eczema, pp. 3 - 24Publisher: Cambridge University PressPrint publication year: 2000
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