Objective

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is complicated by an increased risk for skin and systemic infections. Preventive therapy for AD is based on skin barrier improvement and anti-inflammatory treatments, whereas overt skin and systemic infections require antibiotics or antiviral treatments. This review updates the pathophysiology, diagnosis, management, controversy of antibiotic use, and potential treatments of infectious complications of AD.

Data Sources

Published literature obtained through PubMed database searches and clinical pictures.

Study Selections

Studies relevant to the mechanisms, diagnosis, management, and potential therapy of infectious complications of AD.

Results

Skin barrier defects, type 2 inflammation, Staphylococcus aureus colonization, and cutaneous dysbiosis are the major predisposing factors for the increased infections in AD. Although overt infections require antibiotics, the use of antibiotics in AD exacerbation remains controversial.

Conclusion

Infectious complications are a comorbidity of AD. Although not common, systemic bacterial infections and eczema herpeticum can be life-threatening. Preventive therapy of infections in AD emphasizes skin barrier improvement and anti-inflammatory therapy. The use of antibiotics in AD exacerbation requires further studies.

中文翻译：

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特应性皮炎的感染性并发症。

客观的

特应性皮炎 (AD) 是一种慢性炎症性皮肤病，会增加皮肤和全身感染的风险。AD 的预防性治疗基于改善皮肤屏障和抗炎治疗，而明显的皮肤和全身感染则需要抗生素或抗病毒治疗。本综述更新了 AD 感染性并发症的病理生理学、诊断、管理、抗生素使用争议和潜在治疗方法。

数据源

通过 PubMed 数据库搜索和临床图片获得的已发表文献。

研究选择

与 AD 感染并发症的机制、诊断、管理和潜在治疗相关的研究。

结果

皮肤屏障缺陷、2 型炎症、金黄色 葡萄球菌定植和皮肤生态失调是 AD 感染增加的主要诱发因素。虽然明显的感染需要抗生素，但在 AD 恶化中使用抗生素仍存在争议。

结论

感染性并发症是 AD 的合并症。虽然不常见，但全身性细菌感染和疱疹性湿疹可能会危及生命。AD感染的预防治疗强调改善皮肤屏障和抗炎治疗。在 AD 恶化中使用抗生素需要进一步研究。