Atopic Dermatitis and the Atopic March: What Is New?

Abstract

Objective. In this paper the authors review the management of atopic dermatitis (AD) and the association between AD and allergic respiratory diseases. Data Sources. PubMed databases, researching articles in the last 15 years. Results. Studies about atopic march are cross-sectional population studies at different ages. They show that the most important predisposing factor for atopy is a decrease of the filaggrin's expression. Conclusions. The most modern theories seem to show that the most important factor which starts the atopic march is represented by an impaired epidermal barrier. It causes an increase in skin permeability to allergens that could induce sensitization even in the airways. The major predisposing factor is a primary inherited epithelial barrier defect resulting from filaggrin gene mutation, but other factors may play a role in this complex mechanism. Further studies are needed to focus on AD treatment and preventive strategies.

Mast cells and sphingosine‐1‐phosphate underlie prelesional remodeling in a mouse model of eczema

“…Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting 15‐30% children and 2‐10% adults worldwide . This complex disorder features hypersensitivity to environmental agents and immune dysfunction . Yet, the sequential events leading to eczematous lesions are not completely understood.…”

Efficacy and safety of subcutaneous allergen-specific immunotherapy with depigmented polymerized mite extract in atopic dermatitis

“…7 Thus, sensitization to HDM allergens underlies both the acute flare-ups of AD and the development of a severe, persistent course of the disease, aggravated by cofactors that might together promote the so-called atopic march. 8 There are many other triggers of AD apart from allergens. Complex genetic modifications and certain combinations of environmental and endogenous factors can direct the course of the disease.…”

Self-reported Lifetime Prevalence of Atopic Dermatitis and Co-morbidity with Asthma and Eczema in Adulthood: A Population-based Cross-sectional Survey

“…In a recent Swedish study it was concluded that eczema among adults is more common than previously thought (16) and coexistence with self-reported asthma and rhinitis is common. It is commonly agreed that one major pathogenic factor for AD is a defective skin barrier function (17)(18)(19)(20)(21)(22). This is a major risk factor in the progress of AD in adolescence (23) and for hand eczema (24,25).…”