Atopic Dermatitis: Inside Out or Outside In

Nutrition

Key points Maternal supplementation of omega-3 polyunsaturated fatty acids may reduce risk of atopic dermatitis (AD). Fish intake during early childhood may decrease the risk of developing AD. Early oral introduction of potentially allergenic foods in combination with improved skin…

Immunogens

Key points Patients with atopic dermatitis are more susceptible to developing irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). ICD can present with phenotypic subtypes such as asteatotic ICD, airborne ICD, acneiform ICD, chronic ICD, and acute ICD with…

Skin and Gut Microbiome

Key points The human microbiome consists of a wide variety of microorganisms that assist in key physiologic processes. The majority of microbial diversity is found on the skin and in the gut; and microbial composition is influenced by multiple host…

Skin Barrier

Key points The four layers of the epidermis—stratum corneum, stratum granulosum, stratum spinosum, and stratum basale—are composed of keratinocytes, which undergo differentiation and mature as they become more superficial until they are terminally differentiated at the stratum corneum. The dermis…

Epidemiology

Key points Atopic dermatitis is one of the most common inflammatory diseases of the skin, with both genetic and environmental etiologies. The prevalence of atopic dermatitis is increasing globally due to changes in climate, microbes, urbanization, among other factors. Atopic…

Atopy of the Skin

Key points Atopy of the skin is manifested as atopic dermatitis (atopic eczema). Histologically, the atopy of the skin is characterized by epidermal and dermal infiltration predominantly by lymphocytic cells as well as eosinophils and mast cells. In some patients,…

Atopy Redefined

Key points Although the original term atopy provides a general framework of understanding about allergic clinical conditions, this big umbrella now includes a group of patients who have heterogeneous clinical and laboratory-defined characteristics. Similarly, atopic dermatitis , the skin atopy,…

Historic Perspective

Key points From the historic perspective, atopic dermatitis has gone through several evolutionary periods of understanding and development. From ancient times to the 18th century, medical communities started to recognize a type of itchy skin disease. Although the term eczema…