In his address to the New York Chapter of the Society of Cosmetic Chemists on November 7, 2018 in Fairfield, New Jersey, Dr. Peter M. Elias, M.D. chose as his subject: “Pathogenesis of Atopic Dermatitis”.
In this presentation, he reviewed the pathogenesis of atopic dermatitis as a disorder of the epidermal permeability barrier, including the key role of an elevated pH in initiating several downstream negative consequences for the barrier and immune system. The therapeutic options that derive from this concept include the importance of lowering the pH of the stratum corneum; the putative benefits of suberythemogenic UVB; and a comparison of the mechanisms of action of triple physiologic-based vs. bland moisturizers. Dr. Elias also reviewed his recent studies, showing that most moisturizers do not help the barrier, and are often toxic in individuals with ‘sensitive’ skin, including patients predisposed to develop AD. Finally, he described a new, inexpensive type of instrumentation to measure transepidermal water loss and hydration that should allow patients and caregivers to monitor responses to therapy, and to assess the efficacy of different moisturizers.