The Skin Barrier in Atopic Dermatitis
2011; Linguagem: Inglês
10.1002/9781444345384.ch27
AutoresSimon G. Danby, Michael J. Cork,
Tópico(s)Contact Dermatitis and Allergies
ResumoAtopic dermatitis (AD) is a chronic, inflammatory disease of the skin characterised by xerosis, pruritus and erythematous lesions with increased trans-epidermal water loss (TEWL). AD is associated with a skin barrier defect, which permits the entry of irritants and allergens. Variants within three groups of genes, encoding structural proteins, degradatory proteases and protease inhibitors, predispose to a defective skin barrier. Environmental factors including exposure to house dust mite allergens, the use of soap and detergents and bacterial colonisation interact with these genetic factors to exacerbate skin barrier breakdown. At sites of natural predisposition, where the skin barrier is thinnest, gene-gene and gene-environment factors synergise to create optimum conditions for enhanced skin barrier breakdown. The risk of developing AD is greatest during infancy where the skin barrier is undergoing a period of development and optimisation.
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