Therapeutic Implications of a Barrier-based Pathogenesis of Atopic Dermatitis.
- Author:
Peter M ELIAS
1
Author Information
- Publication Type:Review
- Keywords: Antimicrobial peptides; Atopic dermatitis; Barrier function; Barrier repair
- MeSH: Dermatitis, Atopic; Glucocorticoids; Humidity; Hydrogen-Ion Concentration; Immunologic Factors; Inflammation; Intermediate Filament Proteins; Risk Assessment; Serine Proteases; Staphylococcus aureus; Stress, Psychological
- From:Annals of Dermatology 2010;22(3):245-254
- CountryRepublic of Korea
- Language:English
- Abstract: In this review, I first provide relevant background information about normal epidermal barrier structure and function. I then update recent information about how inherited defects in either filaggrin and/or in the serine protease inhibitor, lymphoepithelial Kazal-type inhibitor 1, converge to stimulate the development of atopic dermatitis (AD). Next I explain the multiple mechanisms whereby a primary barrier abnormality in AD can lead to inflammation. Furthermore, I explore how certain acquired stressors, such as a reduced external humidity, high pH soaps/surfactants, psychological stress, as well as secondary Staphylococcus aureus infections initiate or further aggravate AD. Finally, and most importantly, I compare various therapeutic paradigms for AD, highlighting the risks and benefits of glucocorticoids and immunomodulators vs. corrective, lipid replacement therapy.
