Piquero-Casals Jaime, Carrascosa José Manuel, Morgado-Carrasco Daniel, Narda Mridvika, Trullas Carles, Granger Corinne, Fabbrocini Gabriella
Dermik, Multidisciplinary Dermatology Clinic, Barcelona, Spain.
Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, IGTP, Badalona, Spain.
Dermatol Ther (Heidelb). 2021 Apr;11(2):315-325. doi: 10.1007/s13555-021-00495-y. Epub 2021 Feb 13.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with an estimated prevalence of 10-15% in children and 2-10% in adults. Clinically, there is notable phenotypic variability driven by a complex interaction between genetics, immune function, and the environment. Impairment of the skin barrier plays a significant role in the pathogenesis of AD. The apparent beneficial effect of sunlight in patients with atopic eczema is questioned due to its capacity to disrupt the skin barrier and generate free radicals that can damage proteins, lipids, and DNA. The sum of the external factors that an individual is exposed to throughout their lifetime is termed the exposome. Environmental factors such as sun exposure, temperature, and humidity contribute to both AD flares and regional prevalence variation. Literature on photoprotection in atopic dermatitis is very scarce. The use of adequate sunscreens in atopic dermatitis can ensure the level of photoprotection required to prevent skin photoaging and skin cancer and to mitigate skin barrier dysfunction, decrease inflammation, and neutralize facial redness. Herein we discuss and review the role of UV radiation and the exposome in the etiology of AD, as well as the role of adequate photoprotection.
特应性皮炎（AD）是一种慢性炎症性皮肤病，据估计在儿童中的患病率为10%-15%，在成人中的患病率为2%-10%。临床上，由于遗传、免疫功能和环境之间的复杂相互作用，存在显著的表型变异性。皮肤屏障受损在AD的发病机制中起重要作用。由于阳光有破坏皮肤屏障并产生可损伤蛋白质、脂质和DNA的自由基的能力，其对特应性湿疹患者的明显有益作用受到质疑。个体一生中接触的外部因素总和称为暴露组。诸如阳光照射、温度和湿度等环境因素会导致AD发作以及区域患病率差异。关于特应性皮炎光防护的文献非常稀少。在特应性皮炎中使用适当的防晒霜可确保预防皮肤光老化和皮肤癌以及减轻皮肤屏障功能障碍、减少炎症和消除面部发红所需的光防护水平。在此，我们讨论并综述紫外线辐射和暴露组在AD病因中的作用以及适当光防护的作用。
