Atopic dermatitis (AD) is often complicated by an increased risk for skin and systemic infections. Strategies employing skin barrier improvement and anti-inflammatory treatments can help prevent AD, while overt skin and systemic infections may demand antibiotics or antiviral treatments. 

A recent review discussed the pathophysiology, diagnosis, management, controversy of antibiotic use and potential treatments of infectious complications of AD by exploring PubMed database searches for relevant studies and clinical pictures.

Literature searched showed skin barrier defects, type 2 inflammation, Staphylococcus aureus colonization and cutaneous dysbiosis to be the major predisposing factors for the augmented infections in AD. Despite the need for antibiotics in overt infections, their use in AD exacerbation stays controversial.

Infectious complications are the comorbidities of AD. Although rare, systemic bacterial infections and eczema herpeticum can be fatal. Infections in AD can be prevented by skin barrier improvement and anti-inflammatory therapy; however, using antibiotics for AD exacerbation demands further studies.

Source: Wang V, Boguniewicz J, Boguniewicz M, et al. The infectious complications of atopic dermatitis. Ann Allergy Asthma Immunol. 2021;126(1):3-12.