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Citation
Tags
HERO ID
512183
Reference Type
Journal Article
Subtype
Review
Title
Role of the epidermal barrier in atopic dermatitis
Author(s)
Proksch, E; Folster-Holst, R; Brautigam, M; Sepehrmanesh, M; Pfeiffer, S; Jensen, JM
Year
2009
Is Peer Reviewed?
Yes
Journal
JDDG: Journal der deutschen dermatalogischen Gesellschaft
ISSN:
1610-0379
Volume
7
Issue
10
Page Numbers
899-909
Language
English
PMID
19682176
DOI
10.1111/j.1610-0387.2009.07157.x
Web of Science Id
WOS:000270177700008
Abstract
P>The skin's permeability barrier protects against extensive water loss and prevents the entry into the skin of harmful substances like irritants, allergens and microorganisms. The permeability barrier is mainly located in the stratum corneum and consists of corneocytes and a lipid-enriched intercellular domain. The barrier is formed during epidermal differentiation. In atopic dermatitis the skin barrier is disturbed already in non-lesional skin. The disturbed skin barrier allows the entry of environmental allergens from house dust mites, animal dander and grass pollen into the skin. In predisposed individuals these allergens may trigger via immunologic pathways the inflammation of atopy. The causes for the disturbed epidermal skin barrier are changes in skin lipids and in epidermal differentiation, in particular filaggrin mutations. Filaggrin mutations lead to a disturbed skin barrier and dry skin which are hallmarks in atopic dermatitis. Therapeutic agents influence the skin barrier differently; topical therapy with potent corticosteroids does not lead to the repair of the barrier in atopic dermatitis, whereas therapy with the calcineurin inhibitors and lipid-containing emulsions support barrier repair.
Keywords
atopic dermatitis; skin barrier; lipids; epidermal differentiation; filaggrin; corticosteroid; pimecrolimus; gene-encoding filaggrin; of-function mutations; stratum-corneum; permeability barrier; skin barrier; dry skin; antimicrobial peptides; ichthyosis vulgaris; northern germany; uninvolved skin
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