Chronic Skin Disease and Risk of Infection

In this paper, we review the existing knowledge on the risk of infections in chronic skin disease. The normal skin is a major physiological barrier to most microorganisms. In patients with chronic skin diseases the epidermal barrier function is disrupted and the concentration of antimicrobial peptides may be reduced. Several case series and case-control studies of selected hospitalized patients confirm a high risk of colonization with S. aureus and cutaneous infections among patients with atopic dermatitis, psoriasis, and erythroderma. Cellulitis is a common secondary skin infection associated with leg ulcer, varicose veins, lymphedema, tinea pedis, and leg dermatoses. Pox, Human papilloma, and Herpes viruses, some dermatophytes and candida albicans often give rise to secondary skin infections in chronic skin disease. Concerning infection of other organs than the skin, a few studies have shown that atopic dermatitis patients are more prone to upper and lower respiratory tract infection. One study of severe psoriasis patients has shown increased mortality due to infections. Patients with chronic skin disease may have more severe infections with prolonged periods of antibiotic treatments and worse prognosis compared with skin healthy controls, but more data from population-based studies including detailed data on relevant risk factors and confounders is needed.