In atopic dermatitis, Nonlesional
can be deceiving
Suárez-Fariñas M, et al. Nonlesional atopic dermatitis skin is characterized by broad terminal differentiation defects and variable immune abnormalities. J Allergy Clin Immunol. 2011;127(4):954-964.
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Immunohistochemistry (IHC) staining of terminal differentiation proteins in clinically uninfected/nonlesional atopic dermatitis (ANL), lesional atopic dermatitis (AL), and normal skin. Based on genomic and histologic profiling of both ANL and AL skin lesions (n=12, each), compared with normal human skin (n=10). Scale bar=100 µm.
Current findings show that nonlesional skin exhibits subclinical defects similar to lesional skin, including1,3,4:
In some patients, skin barrier dysfunction, resulting from either genetic defects and/or Th2 immunologic defects, ultimately5,6:
Nonlesional skin in patients with atopic dermatitis is not histologically normal and is indicative of the subclinical inflammation inherent to atopic dermatitis.3,4
Underlying inflammation is a source of lesions and itch, the primary signs and symptoms of atopic dermatitis.2-4 Atopic dermatitis is a chronic inflammatory skin disease that is characterized by intense pruritus and eczematous lesions.7 The Th2 cytokines IL-4 and IL-13 are key drivers involved with the underlying inflammatory process.2