The role of exposome-specific risk factors in atopic dermatitis

The article provides an overview of the latest concepts regarding the role of specific exposomal factors in atopic dermatitis in children and adults. As is known, specific factors include: air pollutants (external, internal), air humidity, metals, water hardness, detergents, pollen and other allergen, diet, human lifestyle factors. In this work, the main attention is paid to all the above factors, except for the role of allergy in the etiopathogenesis of atopic dermatitis (a separate publication will be devoted to this issue). Based on the data of systematic reviews, meta-analyses and recent studies, the role of specific factors is analyzed: air pollutants (external and indoor), diet for pregnant women and during lactation; various dietary supplements, etc. — in the development of atopic dermatitis. It is shown that these (and other exposomal) factors can also participate in the worsening of clinical manifestations of atopic dermatitis (for example, detergents). However, the leading role of any specific factor (factors) in the etiopathogenesis of atopic dermatitis (including allergies) has not been reliably proven to date. This also applies to nutritional factors (for example, adherence to a hypoallergenic diet by the mother during pregnancy and lactation, use of vitamin D and probiotics in the pre- and postnatal periods, etc.). In all likelihood, the external exposome is involved as a risk factor in the development of atopic dermatitis and worsening of the severity of the disease. Nevertheless, measures aimed at improving environmental factors can only be useful, especially in combination with anti-inflammatory drugs.