<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-9190</journal-id>
<journal-title><![CDATA[Revista alergia México]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. alerg. Méx.]]></abbrev-journal-title>
<issn>2448-9190</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Inmunología Clínica y Alergia A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-91902019000400483</article-id>
<article-id pub-id-type="doi">10.29262/ram.v66i4.552</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Dermatitis atópica de inicio tardío con patrón numular]]></article-title>
<article-title xml:lang="en"><![CDATA[Late-onset atopic dermatitis with nummular pattern]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pautt-Lara,]]></surname>
<given-names><![CDATA[Evelia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cala-Castro,]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Harris]]></surname>
<given-names><![CDATA[Olga]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villarinho]]></surname>
<given-names><![CDATA[Ana Luiza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Ciências da Saúde Izamar Milidiú da Silva Servicio de Dermatologia ]]></institution>
<addr-line><![CDATA[ Río de Janeiro]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundação Oswaldo Cruz Centro de Estudos da Saúde do Trabalhador e Ecologia Humana Escola Nacional de Saúde Pública]]></institution>
<addr-line><![CDATA[ Río de Janeiro]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>66</volume>
<numero>4</numero>
<fpage>483</fpage>
<lpage>487</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-91902019000400483&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-91902019000400483&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-91902019000400483&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes:  Los adultos con dermatitis atópica tienen una forma persistente en la infancia o con inicio después de los 18 años. La dermatitis atópica de inicio tardío puede cursar con heterogeneidad clínica y muchas veces sin el patrón clásico de dermatitis flexural.  Caso clínico:  Hombre de 26 años, portador de rinitis alérgica, con eccema de inicio tardío y patrón numular atípico en tronco y miembros. Con la biopsia cutánea se observaron lesiones tipo eccema, lo que asociado con la historia personal y alteraciones en los exámenes de laboratorio, permitió el diagnóstico de dermatitis atópica del adulto de inicio tardío. Se prescribió metotrexato, sin respuesta, por lo que se inició fototerapia debido a la dependencia de corticoides sistémicos.  Conclusión:  Las presentaciones atípicas de la dermatitis atópica en el adulto representan un desafío clínico. La historia personal de atopia, la sensibilidad a aeroalérgenos, la eosinofilia y la biopsia cutánea son esenciales para establecer el diagnóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  Adults with atopic dermatitis have had a persistent form in childhood or with an onset after the age of eighteen years. Late-onset atopic dermatitis may present with clinical heterogeneity and it often lacks the classic pattern of flexural dermatitis.  Clinical case:  A 26-year-old man with allergic rhinitis, with late-onset eczema, and an atypical nummular pattern on his trunk and limbs. The skin biopsy showed eczema-like lesions which, together with the patient&#8217;s personal history and laboratory abnormalities, allowed the diagnosis of the adult&#8217;s late-onset atopic dermatitis. Treatment with methotrexate was started and there was no response, which is why phototherapy was prescribed due to the dependence on systemic corticosteroids.  Conclusion:  Atypical presentations of atopic dermatitis in adults represent a clinical challenge. A personal history of atopy, sensitivity to aeroallergens, eosinophilia, and a cutaneous biopsy are essential to establish the diagnosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dermatitis atópica]]></kwd>
<kwd lng="es"><![CDATA[Heterogeneidad clínica]]></kwd>
<kwd lng="es"><![CDATA[Dermatitis flexural]]></kwd>
<kwd lng="es"><![CDATA[Adultos]]></kwd>
<kwd lng="en"><![CDATA[Atopic dermatitis]]></kwd>
<kwd lng="en"><![CDATA[Clinical heterogeneity]]></kwd>
<kwd lng="en"><![CDATA[Flexural dermatitis]]></kwd>
<kwd lng="en"><![CDATA[Adults]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Querol-Nasarre]]></surname>
<given-names><![CDATA[I.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dermatitis atópica]]></article-title>
<source><![CDATA[Rev Pediatr Aten Primaria.]]></source>
<year>2009</year>
<volume>11</volume>
<numero>Supl 17</numero>
<issue>Supl 17</issue>
<page-range>s317-29</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[HC.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of atopic dermatitis]]></article-title>
<source><![CDATA[Clin Exp Dermatol.]]></source>
<year>2000</year>
<volume>25</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>522-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Katsarou]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Armenaka]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atopic dermatitis in older patients: particular points]]></article-title>
<source><![CDATA[J Eur Acad Dermatol Venereol.]]></source>
<year>2011</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>12-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silvestre-Salvador]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Romero-Pérez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Encabo-Durán]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atopic dermatitis in adults: a diagnostic challenge]]></article-title>
<source><![CDATA[J Investig Allergol Clin Immunol.]]></source>
<year>2017</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>78-88</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Megna]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Patruno]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Balato]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rongioletti]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Stingeni]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Balato]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An Italian multicentre study on adult atopic dermatitis: persistent versus adult-onset disease]]></article-title>
<source><![CDATA[Arch Dermatol Res.]]></source>
<year>2017</year>
<volume>309</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>443-52</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kulthanan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Samutrapong]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Jiamton]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tuchinda]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adult-onset atopic dermatitis: a cross-sectional study of natural history and clinical manifestation]]></article-title>
<source><![CDATA[Asian Pac J Allergy Immunol.]]></source>
<year>2007</year>
<volume>25</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>207-14</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kanwar]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Narang]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adult onset atopic dermatitis: under-recognized or under-reported?]]></article-title>
<source><![CDATA[Indian Dermatol Online J.]]></source>
<year>2013</year>
<volume>4</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>167-71</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reguiaï]]></surname>
<given-names><![CDATA[Z.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dermatite atopique de L&#8217;adulte: présentation clinique, complications et comorbidités]]></article-title>
<source><![CDATA[Ann Dermatol Venereol.]]></source>
<year>2017</year>
<volume>144</volume>
<numero>Suppl 5</numero>
<issue>Suppl 5</issue>
<page-range>VS15-22</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Son]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[BY]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[HO]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[CW.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical features of atopic dermatitis in adults are different according to onset]]></article-title>
<source><![CDATA[J Korean Med Sci.]]></source>
<year>2017</year>
<volume>32</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>1360-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rincón-Pérez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Larenas-Linnemann]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Figueroa-Morales]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Luna-Pech]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[García-Hidalgo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Macías-Weinmann]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mexican consensus on the diagnosis and treatment of atopic dermatitis in adolescents and adults]]></article-title>
<source><![CDATA[Rev Alerg Mex.]]></source>
<year>2018</year>
<volume>65</volume>
<numero>Supl 2</numero>
<issue>Supl 2</issue>
<page-range>s8-s88</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
