Skin Barrier Defects in Atopic Dermatitis

  • Rachana Agrawal
  • Judith A. Woodfolk
Part of the following topical collections:
  1. Topical Collection on Allergic Skin Diseases


Atopic dermatitis (AD) is a chronic inflammatory skin condition with complex etiology that is dependent upon interactions between the host and the environment. Acute skin lesions exhibit the features of a Th2-driven inflammatory disorder, and many patients are highly atopic. The skin barrier plays key roles in immune surveillance and homeostasis, and in preventing penetration of microbial products and allergens. Defects that compromise the structural integrity or else the immune function of the skin barrier play a pivotal role in the pathogenesis of AD. This article provides an overview of the array of molecular building blocks that are essential to maintaining healthy skin. The basis for structural defects in the skin is discussed in relation to AD, with an emphasis on filaggrin and its genetic underpinnings. Aspects of innate immunity, including the role of antimicrobial peptides and proteases, are also discussed.


Atopic dermatitis Th2 Inflammation Skin barrier Skin barrier defects Tight junctions Filaggrin Defensins Proteases Ceramides Epidermis 



atopic dermatitis


antimicrobial peptides








natural moisturizing factors


protease-activated receptor


transepidermal water loss


Compliance with Ethics Guidelines

Conflict of Interest

This work is supported by NIH grants R01 AR059058 and R01 AI052196.

Rachana Agrawal and Judith A. Woodfolk declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Virginia Health SystemCharlottesvilleUSA

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