Atopic dermatitis is a common, complex disease that frequently follows a chronic, relapsing course and impacts 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 simpex virus. A multi-pronged approach directed at healing or protecting the skin barrier and addressing the immune dysregulation is necessary to improve the likelihood of successful outcomes. • Atopic dermatitis is a global health problem, strongly associated with asthma and allergic sensitization.
Keywords• Compared to atopic dermatitis patients without FGN mutations, those patients with atopic dermatitis who have mutations in the FGN gene have disease that is earlier in onset, more severe and more persistent and more likely to be associated with asthma and allergic sensitization.• Most patients with atopic dermatitis are colonized by toxin-secreting S. aureus, even on normal-appearing skin.• Patients with atopic dermatitis with FLG mutations have been found to have an increased risk for eczema herpeticum.• Topical anti-inflammatory measures can reduce S. aureus colonization.What is still unknown?
•The exact relationship between barrier dysfunction and immune dysregulation in atopic dermatitis.• What other skin barrier proteins besides filaggrin are essential for normal barrier function?• A full understanding of why patients with atopic dermatitis compared to other inflammatory dermatoses have more problems with microbial colonization and infection.• Specific biomarkers for atopic dermatitis and unique phenotypes.• Optimal individualized therapy.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
NIH Public AccessAuthor Manuscript J Allergy Clin Immunol. Author manuscript; available in PMC 2011 January 1.
NIH-PA Author ManuscriptNIH-PA Author Manuscript
NIH-PA Author ManuscriptAtopic dermatitis (AD), a complex chronic relapsing inflammatory skin disorder continues to be an important disease worldwide. 1, 2 Lifetime prevalence in school aged children in the United States has been reported to be up to 17%.3 Similarly high prevalence rates have also been observed in a number of other countries.4 Most recently, data on eczema symptoms from over a million children in 97 countries showed that AD is a major problem in developing, as well as developed countries.5 Atopy remains an important as...