Review: Atopic Dermatitis - Exposome, Microbiome, Psyche,and Evolution

Atopic Dermatitis (AD) is probably the most common type of eczema. The quality of life assessment reveals a number of negative consequences for patients with AD and their families. AD is associated with high levels of stress, stigma, social withdrawal, anxiety, depression, and even suicide ideation. Atopic dermatitis is a multisystem inflammatory disease with a multifactorial, and still controversial etiology. Complex interactions between genetic, psychoneuroimmune and endocrine factors, microbiome, exposome and environment, mental and social factors, diet and lifestyle are proposed. AD is difficult to treat, has a chronic course with peaks of exacerbation and pronounced manifestation of mental factors. Such complexity requires deeper understanding of mechanisms behind AD. We consider a possible psychogenic component in diseaseexacerbation, andoffera different point of view onrelationships of human body with the colonizing microbiomein the context of AD etiology and pathogenesis. These relationships are interpreted in evolutionary terms in an attempt to shed some light on mechanisms of chronic and pathological skin processes. Keywords: Atopic Dermatitis; Microbiome; Exposome;Obsessive- Compulsive Disorder