The role of skin barrier function in atopic dermatitis: an update

Atopic dermatitis is the result of complex interactions between environmental and genetic factors influencing the epidermal structure and function, as well as the immune system. Epidermal changes, including the defective epidermal permeability barrier, have recently been intensively investigated recently and seem to be a hallmark of disease pathogenesis. In particular, the detection of filaggrin mutations resulting in a defect in barrier formation has been a landmark finding. However, changes in the lipid metabolism and the expression of endogenous and exogenous proteases, protease inhibitors and tight junction proteins also contribute to the barrier defect in atopic dermatitis.