Barrier function and microbiotic dysbiosis in atopic dermatitis

Abstract

Atopic dermatitis (AD) or atopic eczema is the common inflammatory skin disorder, the prevalence of which has considerably increased during the last 30 years. It affects 15%–30% of children and 2%–10% of adults. AD characteristically alternates between periods of exacerbation or flares and periods of remission, which may be therapeutically induced or spontaneous. Current knowledge about AD includes abnormalities of the skin barrier (physical and chemical), the immune barrier, and more recently, the microbial barrier or microbiota. There is growing evidence for a tight relationship between them. To obtain satisfactory control of this condition, the clinical strategy to manage AD involves prescribing both anti-inflammatory medications and dermocosmetic products. The role of the physician is therefore to advise the patient with regard to hygiene measures aimed to help to improve these three barriers or to prevent any further deterioration.

Keywords:

• atopic dermatitis
• eczema
• skin barrier
• microbiome
• immunity
• dermocosmetic

Acknowledgments

The authors would like to thank N Cleren and G Sore for information provided about the formulation and dosage forms of emollients and R Martin for his microbiological expertise. The authors also acknowledge the editing support of Charlotte Wright (Speak the Speech Consulting).

Disclosure

S Seité is an employee of La Roche-Posay but has no financial interest in the company. T Bieber has been a lecturer for La Roche-Posay. The authors report no other conflicts of interest in this work.