Recent insights into atopic dermatitis and implications for management of infectious complications

• Published in: Journal of allergy and clinical immunology 2010, Vol.125 (1), p.4-13
• Main Authors: Boguniewicz, Mark, MD, Leung, Donald Y.M., MD, PhD
• Format: Article
• Language: English
• Subjects: Accreditation; Allergic diseases; Allergies; Allergy and Immunology; Alzheimer's disease; antimicrobial peptides; Asthma; Atopic dermatitis; Biological and medical sciences; Child, Preschool; Dementia; Dermatitis; Dermatitis, Atopic - complications; Dermatitis, Atopic - immunology; Dermatitis, Atopic - physiopathology; Dermatitis, Atopic - therapy; Dermatitis, Atopic - virology; eczema herpeticum; Education; epidermal barrier; Epidermis - pathology; Epidermis - ultrastructure; filaggrin; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Genes; Herpes Simplex - drug therapy; Herpes Simplex - virology; Herpes simplex virus; Human viral diseases; Humans; Immunopathology; Infectious diseases; Medical sciences; Mutation; Older people; Physicians; probiotics; Proteins; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Simplexvirus - pathogenicity; Skin - microbiology; Skin - pathology; Skin allergic diseases. Stinging insect allergies; Staphylococcal Skin Infections - drug therapy; Staphylococcal Skin Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus - pathogenicity; Staphylococcus infections; superantigens; T regulatory cells; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2009.11.027

Atopic dermatitis (AD) is a common complex disease that frequently follows a chronic relapsing course and affects the quality of life of patients and families in a significant manner. New insights into the pathophysiology of AD point to an important role of structural abnormalities in the epidermis combined with immune dysregulation. Patients with AD have a unique predisposition to colonization or infection by a number of microbial organisms, most notably Staphylococcus aureus and herpes simplex virus. A multipronged approach directed at healing or protecting the skin barrier and addressing the immune dysregulation is necessary to improve the likelihood of successful outcomes.