Skin microbiome and modern treatment options for complicated forms of atopic dermatitis

Abstract

Currently, atopic dermatitis is considered a systemic multifactorial disease, and its development involves various factors, mainly genetic disorders, epidermal barrier impairment, microbiome changes, allergen sensitization, and nonspecific environmental factors. The microbial skin barrier in patients with atopic dermatitis has its characteristics due to changes in the species composition of the microflora toward contamination by conditionally pathogenic microorganisms, which have a significant effect on the disease course, leading to secondary skin infection and exacerbations. Microbes and allergens percutaneously penetrate the disrupted epidermal barrier, leading to sensitization to various proteins, including bacterial and fungal proteins, characterizing the t2 immune response. The treatment of atopic dermatitis aims at achieving long-term control over the disease through an integrated approach, including external and systemic therapy.