Fenotipos y endotipos en dermatitis atópica: articulo de revisión

Introduction: Atopic dermatitis is a heterogeneous disease not only clinically but also in its pathophysiology and genetic bases. Differences can be found regarding the clinical presentation (phenotype) as well as inflammatory profiles or underlying biochemical markers (endotype) that would allow a more specific diagnostic, therapeutic and prognostic classification. Materials and methods: A bibliographic search was carried out in PubMed from the beginning of the database including the terms "atopic dermatitis" AND "endotype OR phenotype." Articles that included the description of phenotypic and endotypic differences in atopic dermatitis as a primary topic, written in English and published in peer-reviewed journals, were reviewed. Likewise, some articles obtained through manual search were included from references of review articles and the use of other databases such as Google Scholar and LILACS. The information collected was summarized, organized and edited through narrative synthesis. Results: The most common phenotypic classifications are given by age, ethnicity/race, IgE levels (in which we distinguish between extrinsic and intrinsic atopic dermatitis) and the presence or absence of atopic comorbidities. By endotypes we can identify multiple underlying inflammatory markers that can vary according to patient groups. Discussion: Currently, therapeutic strategies based on personalized medicine are being proposed through studies that combine these endophenotypic profiles. This article aims to carry out a narrative review that contributes to the knowledge of the different groups of phenotypes and endotypes of a very common but diverse and complex disease.