Epidermal Barrier Dysfunction: Beyond Atopic Dermatitis
نویسنده
چکیده
of the epidermal barrier has expanded greatly over the course of the last two decades. Primary functions of the epidermal barrier are to protect against the entry of foreign substances (antigens, irritants, and microbes). In addition to these primarily defensive roles, the epidermis traps moisture and regulates hydration, and it synthesizes vitamin D. The epidermal barrier is not a passive structure. As keratinocytes mature to horny corneocytes, the epidermis is in a constantly active self-proliferating phase. In addition to physically blocking entry of most foreign substances, the barrier coordinates an immunologic defense against pathogens that manage to bypass the barrier. The structure of the stratum corneum has been described as a bricks-and-mortar structure. The “bricks” are covalently bonded corneocytes arranged in compact, overlapping layers to hold moisture in while keeping allergens, pathogens, and environmental toxins (such as UV radiation) out. The “mortar” consists of ceramides, cholesterol, and lipids. Together, these elements form lipid bilayers that fill the spaces between the corneocytes. This extracellular matrix provides necessary permeability of moisture to the stratum corneum. A majority of research related to epidermal barrier function has focused on classic atopic dermatitis, which has come to be seen as the quintessential disease of barrier dysfunction. However, research continues to show that impaired barrier function contributes to a host of inflammatory dermatoses, including rosacea, acne, and psoriasis. The following provides a closer look at the diagnosis and management of two cutaneous conditions influenced by barrier dysfunction: juvenile plantar dermatitis or wet-to-dry foot syndrome, and head and neck dermatitis. Epidermal Barrier Dysfunction: Beyond Atopic Dermatitis
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تاریخ انتشار 2010