The complex pathophysiology of AD involves not only the visible signs and symptoms on the skin, but also the underlying, persistent inflammation that drives the symptoms.1-3
The AD Disease Process
An ongoing debilitating itch-scratch cycle that involves allergens, an altering of skin microbiome, skin barrier defects in non-lesional skin, and inflammation in lesional skin1-3
The causes of the abnormal skin barrier observed in AD are complex and are driven by a combination of genetic, environmental, and immunologic factors; these factors likely account for the heterogeneity of AD4
The pathophysiology underlying the inflammatory response in AD arises from an exceedingly complex cytokine-mediated intercellular communication network5
Atopic dermatitis is a result of immune dysregulation and skin barrier dysfunction.6,7
Jakasa I, Verberk MM, Esposito M, Bos JD, Kezic S. Altered penetration of polyethylene glycols into uninvolved skin of atopic dermatitis patients. J Invest Dermatol. 2007;127(1):129-134.
May RD, Fung M. Strategies targeting the IL-4/IL-13 axes in disease. Cytokine. 2015;75(1):89-116.
Williams MR, Gallo RL. The role of the skin microbiome in atopic dermatitis. Curr Allergy Asthma Rep. 2015;15(65):1-10.
Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769-779.
Nygaard U, Vestergaard C, Deleuran M. Emerging treatment options in atopic dermatitis: systemic therapies. Dermatology. 2017;233(5):344-357.
Boguniewicz M, Leung DY. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233-246.
Guttman-Yassky E, Waldman A, Ahluwalia J, Ong PY, Eichenfield LF. Atopic dermatitis : pathogenesis. Semin Cutan Med Surg. 2017;36(3):100-103.
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