4.5 Review

Exogenous factors in the pathogenesis of atopic dermatitis: Irritants and cutaneous infections

Journal

CLINICAL AND EXPERIMENTAL ALLERGY
Volume 51, Issue 3, Pages 382-392

Publisher

WILEY
DOI: 10.1111/cea.13820

Keywords

atopic dermatitis; cutaneous infection; immune dysfunction; inflammatory response; irritant; skin microbiota

Funding

  1. Ministry of Education, Culture, Sports, Science and Technology, Japan [26461703]
  2. Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan

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Atopic dermatitis is a chronic inflammatory skin disease that is often associated with other atopic symptoms. The pathogenesis is complex and involves genetic predisposition, immune dysfunction, and environmental factors. Factors like irritation and skin infections play a crucial role in triggering and exacerbating the disease.
Atopic dermatitis (AD) is a chronic relapsing inflammatory cutaneous disease that is often associated with other atopic symptoms, such as food allergy, allergic rhinitis and asthma, leading to significant morbidity and healthcare costs. The pathogenesis of AD is complicated and multifactorial. Although the aetiology of AD remains incompletely understood, recent studies have provided further insight into AD pathophysiology, demonstrating that the interaction among genetic predisposition, immune dysfunction and environmental provocation factors contributes to its development. However, the increasing prevalence of AD suggests that environmental factors such as irritation and cutaneous infection play a crucial role in triggering and/or aggravating the disease. Of note, AD skin is susceptible to bacterial, fungal and viral infections, and microorganisms may colonize the skin and aggravate AD symptoms. Overall, understanding the mechanisms by which these risk factors affect the cutaneous immunity of patients with AD is of great importance for developing a precision medicine approach for treatment. This review summarizes recent developments in exogenous factors involved in the pathogenesis of AD, with special emphasis on irritants and microbial infections.

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