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The author of a thorough review of atopic dermatitis (AD) in the New England Journal of Medicine discusses the epidemiology and clinical presentation of AD; the issue of pruritus; the contributions of genetics, allergens, disrupted barrier function, immunopathologic mechanisms, dendritic cells, T cells, Staphylococcus aureus, and immunoglobulin E (IgE) autoantibodies; and goals for prevention and therapy.
The hallmarks of AD include disrupted skin barrier resulting in dry skin; chronic, relapsing skin inflammation; pruritus; and increased IgE sensitization to food and environmental allergens. AD is a complex genetic disease that arises from gene–gene and gene–environment interactions. Mutations exist in two gene groups: those encoding epider…