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Pathophysiology, Diagnosis, and Management of Infections in Atopic Dermatitis

  • Infectious Disease and Dermatology (K Krishnamurthy and C Beard), Section Editors)
  • Published:
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Abstract

Purpose of Review

Atopic dermatitis (AD) is a common and chronic inflammatory skin disease. The purpose of this review article is to assess recent changes in the understanding of pathophysiology, diagnosis, and management of infections in AD.

Recent Findings

Recent epidemiological studies have confirmed that AD is not only associated with cutaneous infections, but also extra-cutaneous systemic infections. Basic studies have provided evidence that allergic inflammation contribute to increased infections in AD. Clinical use of diluted bleach to prevent infections in AD remains controversial. On the other hand, progress is being made in the study of microbiome in AD. Commensal bacteria may potentially be used to fight Staphylococcus aureus in AD in the future.

Summary

AD is a complex disease arising from skin barrier defects that lead to allergen or pathogen invasion and dysfunctional immune responses that promote inflammation. This inflammatory cycle also alters the skin microbiome so that pathogenic organisms, such as S. aureus, are more likely to colonize the skin. The skin barrier defects, immune dysregulation, and alteration in the skin microbiome lead to an increased risk for secondary bacterial and viral infections. More targeted therapies and skin probiotics may address inflammation and S. aureus in the prevention of infections in AD.

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Authors and Affiliations

  1. Division of Pediatrics, Children’s Hospital Los Angeles, 4650 Sunset Boulevard, MS 75, Los Angeles, CA, 90027, USA

    Grace Chan

  2. Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA

    Peck Y. Ong

  3. Division of Clinical Immunology and Allergy, Children’s Hospital Los Angeles, 4650 Sunset Boulevard, MS 75, Los Angeles, CA, 90027, USA

    Peck Y. Ong

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Grace Chan declares no conflict of interest.

Peck Y. Ong reports personal fees from Pfizer, grants from Regeneron, grants from Incyte, and grants from the Atopic Dermatitis Research Network.

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Chan, G., Ong, P.Y. Pathophysiology, Diagnosis, and Management of Infections in Atopic Dermatitis. Curr Derm Rep 8, 73–79 (2019). https://doi.org/10.1007/s13671-019-0256-y

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