Atopic dermatitis triggering factors
Mireia, living with Atopic Dermatitis
What causes atopic dermatitis?
The exact cause of atopic dermatitis is not completely clear; It has a complex set of causes that includes genetic and environmental factors leading to abnormalities in the epidermis and the immune system, so it is also commonly associated with other atopic manifestations (atopic march), such as food allergy, allergic rhinitis and asthma.
Defects in the skin barrier
Regarding the role of the skin barrier in the occurrence of AD, current evidence suggests that it is due to a primary defect of the skin barrier that facilitates the development of other atopic conditions. These skin barrier abnormalities lead to the loss of transepidermal water (water passes from inside the body through the epidermal layer of the skin, to the surrounding atmosphere) and a higher penetration of allergens and microbes in the skin, which may trigger the inflammation.
Genetic alterations
These include loss-of-function and mutations in a protein called filaggrin. It has also been proven that there is a deficiency in lipid molecules (ceramides), as well as in antimicrobial peptides (cathelicidins), the first line of defense against many infectious agents.
Infectious agents
The most commonly involved infectious agent in AD is Staphylococcus aureus (S. aureus).
Defects in the immune response
Defective innate immune responses also seem to contribute to an increase in bacterial and viral infections in patients with atopic dermatitis.
References
- Kolb, L., Ferrer-Bruker, S.J. Atopic dermatitis. StatPearls - NCBI Bookshelf. 2020.
- Avena-Woods C. Overview of atopic dermatitis. AJMC. 2017;1–10.
- Kezic, S., Novak, N., Jakasa, I., Jungersted, J.M., Simon, M., Brandner, J.M., et al. Skin barrier in atopic dermatitis. Front Biosci. 2012;19:542–56.
- Kapur, S., Watson, W., Carr, S. Atopic dermatitis. Allergy Asthma Clin Immunol. 2018;14(s2):1–10.