Skin microbiome in atopic dermatitis

Currently, atopic dermatitis is considered as a systemic multifactorial disease, the development of which involves many factors, the main of which are genetic disorders, dysfunction of the epidermal barrier, changes in the microbiome, sensitization to allergens and the influence of nonspecific environmental factors. The microbial barrier of the skin in patients with atopic dermatitis has its own characteristics due to changes in the species composition of the microflora towards contamination by conditionally pathogenic microorganisms, which, in turn, have a significant effect on the course of the disease, leading to secondary infection of the skin and the development of exacerbations. Through the disrupted epidermal barrier, percutaneous penetration of microbes and allergens occurs, sensitization to various proteins, including proteins of bacteria and fungi, characterizing the t2 immune response. Treatment of atopic dermatitis is aimed at achieving long-term control over the disease and provides an integrated approach, including external and systemic therapy.