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Atopic dermatitis (AD) is one of the most common inflammatory skin diseases in the western world. Multiple causes have been implicated in the pathogenesis of atopic dermatitis, however in the past years many studies have highlighted the pathogenic role played by abnormal skin barrier in patients with AD. Impaired skin barriers facilitate the penetration of environmental agents/allergens into the skin with resultant chronic inflammation and atopic march. Many components of the epidermal barrier are impaired in atopic dermatitis including intracellular proteins comprising the cornified cell envelope, inter-cellular lipids and their metabolism, inter-cellular junctions and desquamation process. Investigating skin barrier abnormalities and understanding the mechanisms for its maintenance, are crucial for improving the management of AD patients and preventing the development of atopic march. Here we review the latest developments in skin barrier dysfunction in AD with associated clinical implications.


Journal Details

This article was published in the following journal.

Name: Harefuah
ISSN: 0017-7768
Pages: 43-48


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Medical and Biotech [MESH] Definitions

The widespread involvement of the skin by a scaly, erythematous dermatitis occurring either as a secondary or reactive process to an underlying cutaneous disorder (e.g., atopic dermatitis, psoriasis, etc.), or as a primary or idiopathic disease. It is often associated with the loss of hair and nails, hyperkeratosis of the palms and soles, and pruritus. (From Dorland, 27th ed)

Rare autosomal recessive disease with variable expressions. Clinical features of the disease include variable ICHTHYOSIFORM ERYTHRODERMA, CONGENITAL; bamboo hair (trichorrhexis invaginata); and ATOPIC DERMATITIS. The disease is caused by mutations in the SPINK5 gene.

A disseminated vesicular-pustular eruption caused by the herpes simplex virus (HERPESVIRUS HOMINIS), the VACCINIA VIRUS, or Varicella zoster (HERPESVIRUS 3, HUMAN). It is usually superimposed on a preexisting, inactive or active, atopic dermatitis (DERMATITIS, ATOPIC).

Antigens from the house dust mites (DERMATOPHAGOIDES), mainly D. farinae and D. pteronyssinus. They are proteins, found in mite feces or mite extracts, that can cause ASTHMA and other allergic diseases such as perennial rhinitis (RHINITIS, ALLERGIC, PERENNIAL) and atopic dermatitis (DERMATITIS, ATOPIC). More than 11 groups of Dermatophagoides ALLERGENS have been defined. Group I allergens, such as Der f I and Der p I from the above two species, are among the strongest mite immunogens in humans.

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