AD, Environment, and Diet

The pathogenesis of atopic dermatitis (AD) involves multiple elements including cutaneous microbiome perturbation, disruption of the skin barrier, genetic susceptibility, and altered immune response. We review the role of environmental and dietary exposures in AD pathogenesis. We highlight the effects of environmental exposures on the molecular and cellular pathways involved in AD. Additionally, we present a patient that responded well to heliotherapy. Although diet has been known to be associated with AD, much remains unknown. Patients and clinicians may struggle to distinguish between exacerbations of AD and true food allergies (FA), secondary to specific dietary exposures. We discuss various adverse reactions to food and discuss current methods of investigation and diagnosis. Based on our current understanding, it appears that a compromised skin barrier and skin and gut microbiome dysbiosis are associated with both AD and FA. Lastly, the role of oral supplements and vitamins in the management of AD is discussed.