Is the face and neck pattern of atopic dermatitis in Japan a special variant?

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Abstract
Adult atopic dermatitis (AD) with severe and refractory eruptions on the face, neck, and upper trunk, although quite rare in western countries, has increased in Japan. We have tried to clarify the possible causative factors for this particular type of AD, predominantly seen in Japan. Eighty-seven AD patients (37 men and 50 women) who had severe and refractory facial and neck lesions were patch tested with topical medicaments, cosmetics, and skin-management products. Thirty-seven (42. 5%) patients showed positive reactions to more than one of those products: 14 patients to shampoo, rinse, or soap; 11 to topical nonsteroidal anti-inflammatory agents (NSAIDs); 7 to cosmetics; and 6 to corticosteroids. We believe that topical NSAIDs, (which are often prescribed for the treatment of AD in Japan and rarely used for the treatment of eczamatous skin disorders in western countries), as well as common detergents, play important roles in the increased prevalence of AD patients with severe and refractory lesions on the face, neck, and upper trunk in Japan.

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