Understanding Infantile Atopic Dermatitis: A Review of Environmental, Familial, Genetic and Microbial Influences

This review aims to clarify the early-life risk and protective factors associated with Infantile Atopic Dermatitis (IAD)-an inflammatory skin condition that typically develops between birth and two years of age. The goal was to examine recent findings on maternal, environmental, and microbial influences on IAD.

Prenatal and postpartum maternal probiotic use may reduce IAD risk, though no significant alterations in infants' gut microbiota were found. Infants with IAD exhibit higher Clostridia levels, while Verrucomicrobia are more abundant in non-IAD cases. Breastmilk from the mother of affected infants contains higher arachidonic acid and lower eicosapentaenoic acid, whereas formula-feeding may lower IAD risk. Seasonal influences such as reduced sunlight or humidity are associated with higher susceptibility. Elevated skin biomarkers, including TARC/CCL17 and IL-8, have been observed in infants who later develop IAD. Early antibiotic exposure, particularly during the first trimester, also increases risk.  IAD is multifactorial, involving genetics, environment, and skin barrier dysfunction. Understanding the interplay between the microbiome, maternal influences, and environmental exposures may guide future preventive approaches. Further research into non-pharmacologic and microbiome-targeted interventions is warranted to delay or prevent IAD onset.