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Pathophysiology of AD

The complex pathophysiology of AD involves not only the visible signs and symptoms on the skin, but also the underlying, persistent inflammation that drives the symptoms.1-3
graphic created by to show the atopic dermatitis disease process

The AD Disease Process

  • An ongoing debilitating itch-scratch cycle that involves allergens, an altering of skin microbiome, skin barrier defects in non-lesional skin, and inflammation in lesional skin1-3
  • The causes of the abnormal skin barrier observed in AD are complex and are driven by a combination of genetic, environmental, and immunologic factors; these factors likely account for the heterogeneity of AD4
  • The pathophysiology underlying the inflammatory response in AD arises from an exceedingly complex cytokine-mediated intercellular communication network5

Atopic dermatitis is a result of immune dysregulation and skin barrier dysfunction.6,7

  1. Jakasa I, Verberk MM, Esposito M, Bos JD, Kezic S. Altered penetration of polyethylene glycols into uninvolved skin of atopic dermatitis patients. J Invest Dermatol. 2007;127(1):129-134.
  2. May RD, Fung M. Strategies targeting the IL-4/IL-13 axes in disease. Cytokine. 2015;75(1):89-116.
  3. Williams MR, Gallo RL. The role of the skin microbiome in atopic dermatitis. Curr Allergy Asthma Rep. 2015;15(65):1-10.
  4. Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769-779.
  5. Nygaard U, Vestergaard C, Deleuran M. Emerging treatment options in atopic dermatitis: systemic therapies. Dermatology. 2017;233(5):344-357.
  6. Boguniewicz M, Leung DY. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233-246.
  7. Guttman-Yassky E, Waldman A, Ahluwalia J, Ong PY, Eichenfield LF. Atopic dermatitis : pathogenesis. Semin Cutan Med Surg. 2017;36(3):100-103.