Atopic dermatitis triggers

Li M, Messaddeq N, Teletin M, Pasquali JL, Metzger D, Chambon P Retinoid X receptor ablation in adult mouse keratinocytes generates an atopic dermatitis triggered by thymic stromal lymphopoietic Proc Natl Acad Sci USA 2005 102 14795-14800. 

Keratinocytes secrete a unique profile of chemo-kines and cytokines after exposure to proinflam-matory cytokines. Keratinocyte-derived thymic stromal lymphopoietin (TSLP) may be of particular importance in atopic dermatitis This protein is undetectable in normal skin or non-lesional skin in patients with atopic dermatitis, but is highly expressed in acute and chronic atopic dermatitis lesions [18]. TSLP instructs human dendritic cells to create a Th-2-permissive microenvironment by inducing the expression of OX40L which triggers the differentiation of inflammatory Th-2 cells [48]. 

Dust has been recognised as a trigger for asthma for many years and the allergens are present in the faeces of the house dust mite, of genus Dermatophagoides. They are members of the order Arachnida (close relatives of ticks and spiders). They live off human skin that has been shed and hence are present in bedding and carpets. Since they are not visible to the naked eye and are difficnlt to control, they can be overlooked as the canse of this distressing disease. They may also be a cause of perennial rhinitis and atopic dermatitis. 

An algorithm for the treatment of atopic dermatitis is provided in Fig. 17-1. Possible aggravating factors that may trigger a flare-up should be identified and avoided. 

Control of atopic dermatitis flare-ups includes identification and elimination of trigger allergens, as well as maintenance of skin patency. 

Atopic dermatitis limited to the face. The distinction between both conditions is difficult to assess in many cases. The complexity of the problem has increased in recent years due to the knowledge that facial signs of atopic dermatitis could be triggered, worsened or even provoked by various allergens of... 

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