Atopic Dermatitis

Abstract

Atopic dermatitis (AD) is the most common chronic and relapsing, pruritic, inflammatory skin disease that affects both children and adults with a prevalence of up to 18% and 7%, respectively. The atopic dermatitis pathogenesis is multifactorial: epidermal barrier dysfunction, immunological abnormalities as antimicrobial peptides deficiency, host genetics as null mutations in the gene encoding the epidermal structural protein filaggrin (FLG) and missense variants in genes encoding the T_H2 signature cytokine IL-13 and IL-6R, altered skin microbiota, and environmental factors. AD patients have an increased risk of bacterial, viral, and fungal infections, such as S. aureus, Herpes simplex, Molluscum, and Malassezia. Some endotypes are associated with a higher risk for the atopic march: early onset AD, those with polysensitization, with an atopic parent, with a persistent or severe endotype, and those with a filaggrin mutation.