ABSTRACT
Atopic dermatitis (AD) patients experience a much higher frequency of staphylococcal infections than people without AD, studies document only increased colonization and impetiginized eczema, uncommonly clinically severe infections. Staphylococcus Aureus is a common cause of cutaneous infections such as folliculitis, furunculosis, abscesses, cellulitis, and necrotizing soft tissue infections. Staphylococcal colonization is also favored by the more alkaline pH of AD skin and the presence in dermatitic skin of exposed fibrinogen and fibronectin, which facilitate binding of staphylococci. Treatment of bacterial skin infection in eczema is targeted at the most likely causative organism, S. aureus. Some studies have reported an increased risk of streptococcal infections in patients with acute flares of AD. Several studies suggest improvement of AD with systemic antifungal therapy, especially with ‘azoles’. Specific serum Immunoglobulin E, positive skin-prick tests and positive atopy patch tests to Malassezia spp. have been demonstrated repeatedly in patients with AD.
