Understanding worldwide skin atopy across regions. Environmental, cultural, genetic, and lifestyle factors

Cutaneous atopy, which predominantly manifests as atopic dermatitis (AD), represents a significant global health concern due to its high prevalence and profound impact on patients' quality of life. AD affects up to 20% of children and 10% of adults worldwide, with a rising incidence in both industrialized and developing regions. While genetic predisposition is a key determinant, most existing literature analyzes risk factors in isolation, limiting a comprehensive understanding of the disease. This article provides an integrative, regionally informed perspective on how environmental, cultural, genetic, and lifestyle factors may interact to shape the clinical expression of cutaneous atopy in diverse populations and regions. Drawing on published evidence and insights from an international expert panel, we highlight the complexity and multifactorial nature of the atopic environment, emphasizing the simultaneous disruption of the four key skin barriers-physical, chemical, immunological, and microbial-in AD. The article further addresses how regional differences in barrier function and the influence of urban versus rural living conditions can affect disease manifestation, underlining the need for personalized and holistic therapeutic strategies. This integrative perspective aims to offer healthcare professionals an updated framework for the management of AD, enabling more effective interventions tailored to the realities of diverse patient populations.