Clinical Characterization and Underlying Pathophysiological Mechanisms in Atopic Dermatitis: A Comprehensive Exploration of its Clinical Presentation and Emerging Therapeutic Perspectives

Abstract

Atopic dermatitis, a chronic inflammatory skin disease of a predominantly genetic nature, has attracted continued interest in the field of dermatology and immunology due to its pathophysiological complexity and its significant impact on patients' quality of life. In this article, we present a comprehensive review of the current literature on atopic dermatitis, addressing its clinical characterization from a holistic perspective and the underlying pathophysiologic mechanisms that define it. From a clinical point of view, the heterogeneity of cutaneous manifestations in atopic dermatitis is highlighted, including erythema, intense pruritus, lichenification and exudation. In addition, the variability of clinical presentations throughout the different stages of life is explored, focusing on early childhood and adulthood, which underlines the need for a multidisciplinary and personalized approach to its management. In terms of pathophysiological mechanisms, the dysfunction of the skin barrier, the dysregulated immune response and the involvement of key cytokines in the perpetuation of the inflammatory process are examined in detail. The interaction between genetic and environmental factors in the development and exacerbation of the disease is discussed, as well as the connection between atopic dermatitis and other atopic conditions, such as asthma and allergic rhinitis. In addition, conventional and emerging therapies for atopic dermatitis, including topical corticosteroids, calcineurin inhibitors, biologic therapies, and approaches aimed at modulating the skin microbiota, are discussed. The importance of patient education, skin care strategies and a comprehensive approach to achieve effective symptom control and prevent recurrences is emphasized. In summary, this article provides a comprehensive view of atopic dermatitis, merging its clinical and pathophysiological aspects. Advanced understanding of the clinical diversity and underlying mechanisms is crucial for an informed and optimal management of this constantly evolving chronic skin condition.