The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

DOI

  • H. Alexander, Kings Coll London, Kings College London, University of London, Dept Psychosis Studies, Inst Psychiat Psychol & Neurosci
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  • A. S. Paller, Northwestern Univ, Northwestern University, Feinberg School of Medicine, Dept Pediat, Feinberg Sch Med
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  • C. Traidl-Hoffmann, Christine Kuhne Ctr Allergy Res & Educ CK CARE
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  • L. A. Beck, Univ Rochester, University of Rochester, Dept Dermatol, Med Ctr
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  • A. De Benedetto, Univ Florida, State University System of Florida, University of Florida, Coll Med, Dept Dermatol
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  • S. Dhar, Inst Child Hlth, Dept Pediat Dermatol
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  • G. Girolomoni, Univ Verona, University of Verona, Sect Dermatol & Venereol, Dept Med
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  • A. D. Irvine, Natl Childrens Res Ctr, National Children's Research Centre (NCRC), Trinity College Dublin
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  • P. Spuls, Univ Amsterdam, University of Amsterdam, Amsterdam UMC, Amsterdam Publ Hlth Infect & Immun, Dept Dermatol
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  • J. Su, Univ Melbourne, Murdoch Children's Research Institute, University of Melbourne, Murdoch Childrens Res Inst, Dept Dermatol, Univ Melbourne, Murdoch Children's Research Institute, University of Melbourne, Murdoch Childrens Res Inst, Dept Paediat, Monash Univ, Monash University, Eastern Hlth
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  • J. P. Thyssen, Herlev Gentofte Hosp, Dept Dermatol & Allergy
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  • C. Vestergaard
  • T. Werfel, Hannover Med Sch, Hannover Medical School, Dept Dermatol & Allergy
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  • A. Wollenberg, Ludwig Maximilians Univ Munchen, University of Munich, Dept Dermatol & Allergol
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  • M. Deleuran
  • C. Flohr, Kings Coll London, Kings College London, University of London, Dept Psychosis Studies, Inst Psychiat Psychol & Neurosci

Patients with atopic dermatitis (AD) have an increased risk of bacterial skin infections, which cause significant morbidity and, if untreated, may become systemic. Staphylococcus aureus colonizes the skin of most patients with AD and is the most common organism to cause infections. Overt bacterial infection is easily recognized by the appearance of weeping lesions, honey-coloured crusts and pustules. However, the wide variability in clinical presentation of bacterial infection in AD and the inherent features of AD - cutaneous erythema and warmth, oozing associated with oedema, and regional lymphadenopathy - overlap with those of infection, making clinical diagnosis challenging. Furthermore, some features may be masked because of anatomical site- and skin-type-specific features, and the high frequency of S. aureus colonization in AD makes positive skin swab culture of suspected infection unreliable as a diagnostic tool. The host mechanisms and microbial virulence factors that underlie S. aureus colonization and infection in AD are incompletely understood. The aim of this article is to present the latest evidence from animal and human studies, including recent microbiome research, to define the clinical features of bacterial infections in AD, and to summarize our current understanding of the host and bacterial factors that influence microbial colonization and virulence.

Original languageEnglish
JournalBritish Journal of Dermatology
Volume182
Issue6
Pages (from-to)1331-1342
ISSN0007-0963
DOIs
Publication statusPublished - Jun 2020

    Research areas

  • RESISTANT STAPHYLOCOCCUS-AUREUS, INNATE IMMUNE-RESPONSE, METHICILLIN-RESISTANT, TOPICAL CORTICOSTEROIDS, ANTIMICROBIAL PEPTIDES, FILAGGRIN EXPRESSION, SYSTEMIC INFECTIONS, CLINICAL-FEATURES, CYTOKINE MILIEU, INCREASED RISK

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