Atopic dermatitis: a mini review on pathology and treatment modalities

Abstract

The symptoms of atopic dermatitis (AD), a chronic, recurrent inflammatory skin condition, include immunological dysregulation, severe pruritus, and malfunctioning of the epidermal barrier. Recent developments in our understanding of AD’s molecular and immunological pathways have shed light on the functions of cytokines, including interleukin (IL)-4, IL-13, IL-31, and IL-22, as well as the impact of genetic mutations in filaggrin and other barrier proteins. Inflammation and barrier dysfunction are further aggravated by microbial dysbiosis, especially colonisation of Staphylococcus aureus. Treatment options include topical corticosteroids, topical calcineurin inhibitors, targeted biologics, and small-molecule inhibitors that alter the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) and phosphodiesterase 4 (PDE4) pathways, as well as Mn- and Fe-porphyrin ring-based topical formulations. Even with these advancements, tailored treatment and long-term illness control are still challenging to achieve. New strategies that emphasise gene therapy and microbiome restoration can potentially improve the accuracy and comprehensiveness of AD treatment.

Keywords

epidermal barrier dysfunction / filaggrin / emollients / neuro-immune modulation / phototherapy

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