Premium
Role of the epidermal barrier in atopic dermatitis
Author(s) -
Proksch Ehrhardt,
FölsterHolst Regina,
Bräutigam Matthias,
Sepehrmanesh Marjan,
Pfeiffer Stephan,
Jensen JensMichael
Publication year - 2009
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2009.07157.x
Subject(s) - filaggrin , stratum corneum , atopic dermatitis , skin barrier , transepidermal water loss , corneocyte , dermatology , dander , barrier function , immunology , dry skin , medicine , chemistry , biology , allergy , pathology , allergen , microbiology and biotechnology
Summary The skin's permeability barrier protects against extensive water loss and prevents the entry into the skin of harmful substances like irritants, allergens and microorganisms. The permeability barrier is mainly located in the stratum corneum and consists of corneocytes and a lipid‐enriched intercellular domain. The barrier is formed during epidermal differentiation. In atopic dermatitis the skin barrier is disturbed already in non‐lesional skin. The disturbed skin barrier allows the entry of environmental allergens from house dust mites, animal dander and grass pollen into the skin. In predisposed individuals these allergens may trigger via immunologic pathways the inflammation of atopy. The causes for the disturbed epidermal skin barrier are changes in skin lipids and in epidermal differentiation, in particular filaggrin mutations. Filaggrin mutations lead to a disturbed skin barrier and dry skin which are hallmarks in atopic dermatitis. Therapeutic agents influence the skin barrier differently; topical therapy with potent corticosteroids does not lead to the repair of the barrier in atopic dermatitis, whereas therapy with the calcineurin inhibitors and lipid‐containing emulsions support barrier repair.