The infectious complications of atopic dermatitis

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is complicated by an increased risk for skin and systemic infections. Preventive therapy for AD is based on skin barrier improvement and anti-inflammatory treatments, whereas overt skin and systemic infections require antibiotics or anti-viral treatments. This review updates the pathophysiology, diagnosis, management, controversy of antibiotic use, and potential treatments of AD infectious complications. Data Sources Published literature obtained through PubMed searches and clinical pictures. Study Selections Studies relevant to the mechanisms, diagnosis, management and potential therapy of AD infectious complications. Results Skin barrier defects, type 2 inflammation, S. aureus colonization and cutaneous dysbiosis are the major predisposing factors for the increased infections in AD. While overt infections require antibiotics, the use of antibiotics in AD exacerbation remains controversial. Conclusion Infectious complications are a co-morbidity of AD. Although not common, systemic bacterial infections and eczema herpeticum can be life-threatening. Preventive therapy of infections in AD emphasizes skin barrier improvement and anti- inflammatory therapy. The use of antibiotics in AD exacerbation requires further studies.