[ATOPIC DERMATITIS AS A PRIMARY EPIDERMAL DISEASE: CLINICAL IMPLICATIONS]

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases in the western world. Multiple causes have been implicated in the pathogenesis of atopic dermatitis, however in the past years many studies have highlighted the pathogenic role played by abnormal skin barrier in patients with AD. Impaired skin barriers facilitate the penetration of environmental agents/allergens into the skin with resultant chronic inflammation and atopic march. Many components of the epidermal barrier are impaired in atopic dermatitis including intracellular proteins comprising the cornified cell envelope, inter-cellular lipids and their metabolism, inter-cellular junctions and desquamation process. Investigating skin barrier abnormalities and understanding the mechanisms for its maintenance, are crucial for improving the management of AD patients and preventing the development of atopic march. Here we review the latest developments in skin barrier dysfunction in AD with associated clinical implications.