Head and neck dermatitis (HND) is a unique subtype of atopic dermatitis (AD) which commonly manifests in late adolescence or adulthood. HND is often refractory to therapy and affects patient’s quality of life greatly. However, presence of HND is often underappreciated in clinics and detailed studies on its characteristics are limited.
This study sought to analyze clinical, histological characteristics of HND patients. Further, as there is a growing number of AD studies focusing on the role of skin microbiome in the disease pathogenesis, microbiome analysis of HND patients in comparison to non-HND (N-HND) AD and normal (NL) subjects was performed.
The results showed HND patients comprising approximately 2.4% of AD patients in an outpatient clinic setting. Compared to N-HND patients, HND initially presented with more severe disease status and elevated serum total IgE and serum specific IgE eactivity to dermatophagoides farinae. Histologically, HND specimen showed thickened epidermis with increased vascular components and dermal inflammatory infiltrates staining positive to pro-inflammatory cytokines and chemokines. Lastly, the microbiome analysis of HND in comparison to N-HND AD and NL subjects revealed presence of diverse community present in the skin.
These findings reaffirm that HND is a clinical subtype of AD that needs distinction from classical AD. In the future, further investigation of skin microbiome and inflammatory factors involved in vasculatures of facial lesions in AD will lead to development of potential therapeutic targets.