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Allergy Asthma Respir Dis. 2020 Jan;8(1):9-14. Korean.
Published online Jan 31, 2020.
© 2020 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
Phenotypes and endotypes of atopic dermatitis: Clinical implications
Minji Kim,1 and Jihyun Kim2,3
1Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Dongtan, Korea.
2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.

Correspondence to: Jihyun Kim. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-3539, Fax: +82-2-3410-0805, Email:
Received May 30, 2019; Revised Aug 06, 2019; Accepted Aug 06, 2019.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (


Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, characterized by a complex pathophysiology and a variety of clinical phenotypes. However, heterogeneous clinical phenotypes are generally not considered in treating AD. To date, phenotypes and endotypes have been proposed to classify AD mainly based on differences in age, IgE, severity, race, skin barrier dysfunction, immune (Th2/Th17/Th22) polarization, and skin microbiome. Various biologics to target polarized immune pathways, including dupilumab, have been newly developed for the personalized treatment of moderate-to-severe AD. Further understanding of AD pathophysiology and identification of novel biomarkers will not only allow clinically useful stratification of AD and but also achieve precision medicine for the prevention and treatment of AD.

Keywords: Atopic dermatitis; Biomarker; Endotype; Phenotype; Precision medicine


Fig. 1
Overview of atopic dermatitis phenotypes and endotypes. Th, T-helper type; IFN, interferon; IL, interleukin; TSLP, thymic stromal lymphopoietin. S. aureus, Staphylococcus aureus.
Click for larger imageDownload as PowerPoint slide


This study was funded by the Environmental Health Center Project of the Ministry of Environment, Republic of Korea.

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