St John's Institute of Dermatology, King's College London, London, U.K.
Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Br J Dermatol. 2019 Mar;180(3):464-474. doi: 10.1111/bjd.16934. Epub 2018 Oct 10.
Atopic dermatitis is the most common chronic inflammatory skin disorder, affecting up to 20% of children and 10% of adults in industrialized countries. This highly debilitating condition poses a considerable burden to both the individual and society at large. The pathophysiology of atopic dermatitis is complex, encompassing both genetic and environmental risk factors.
This is a narrative review based on a systematic literature search.
Dysregulation of innate and adaptive immunity plays a key role; however, recent epidemiological, genetic and molecular research has focused interest on skin barrier dysfunction as a common precursor and pathological feature. Current understanding of the aetiology of atopic dermatitis highlights disruption of the epidermal barrier leading to increased permeability of the epidermis, pathological inflammation in the skin, and percutaneous sensitization to allergens. Thus, most novel treatment strategies seek to target specific aspects of the skin barrier or cutaneous inflammation. Several studies have also shown promise in preventing atopic dermatitis, such as the early use of emollients in high-risk infants. This may have broader implications in terms of halting the progression to atopic comorbidities including food allergy, hay fever and asthma.
特应性皮炎是最常见的慢性炎症性皮肤病，在工业化国家，多达 20%的儿童和 10%的成年人受到影响。这种高度衰弱的疾病给个人和整个社会都带来了相当大的负担。特应性皮炎的病理生理学很复杂，包括遗传和环境风险因素。
这是一篇基于系统文献检索的叙述性综述。
先天和适应性免疫的失调起着关键作用；然而，最近的流行病学、遗传学和分子研究将兴趣集中在皮肤屏障功能障碍作为共同的前体和病理特征上。目前对特应性皮炎病因的理解强调了表皮屏障的破坏导致表皮通透性增加、皮肤的病理性炎症以及对过敏原的经皮致敏。因此，大多数新的治疗策略都试图针对皮肤屏障或皮肤炎症的特定方面。一些研究也在预防特应性皮炎方面显示出了希望，例如在高风险婴儿中早期使用保湿剂。这可能在阻止特应性合并症（包括食物过敏、花粉热和哮喘）的进展方面具有更广泛的意义。
