The ins and outs of an 'outside-in' view of allergies: atopic dermatitis and allergy prevention

Current Opinion in Pediatrics
Marcus ShakerJulianne A Mann

Abstract

The skin barrier is a dynamic innate immune organ. This review summarizes the current understanding of how deficiencies associated with atopic dermatitis invite other atopic disorders of the allergic march. Atopic dermatitis is characterized by skin barrier defects (such as mutations in filaggrin), intrinsic proallergic T-helper cell 2 immune dysregulation, and skin microbiome alterations. These factors promote the development of food allergy and asthma. Prevention of atopic dermatitis may involve topical emollients and oral probiotic supplementation, while some food allergies can be prevented by early introduction of potential food allergens to at-risk infants. Traditional therapies for atopic dermatitis involve skin hydration, emollients, and anti-inflammatory topical therapies including topical corticosteroids and calcineurin inhibitors. Dupilumab is a new and promising targeted biologic medication approved for use in adults with more severe atopic dermatitis; however, additional research is needed to determine whether this medication should be incorporated more broadly into management of severe childhood atopic dermatitis. Atopic dermatitis management involves early diagnosis, skin barrier function support, mitigation of cu...Continue Reading

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Citations

Apr 3, 2019·Current Opinion in Pediatrics·Diana ChernikovaMarcus Shaker
Apr 3, 2019·Current Opinion in Pediatrics·Dana ToyMarcus Shaker
Feb 26, 2019·Frontiers in Pediatrics·Stefania ArasiAlessandro G Fiocchi
May 16, 2019·Current Opinion in Pediatrics·Diana ChernikovaMarcus Shaker
Mar 12, 2019·The Journal of Clinical Investigation·Nurit P Azouz, Marc E Rothenberg
May 16, 2019·Current Opinion in Pediatrics·Dana ToyMarcus Shaker

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