New! The Outside-Inside Model of Disease Pathogenesis

The outside-in view is based upon recent advances in molecular genetics which have increased awareness that the skin barrier is a dynamic interface with a hostile outside environment, which shows that genetic defects compromises skin barrier, leading to atopic dermatitis. This barrier defect then causes downstream changes that lead to inflammation, what allows, increased allergen penetration across the stratum corneum, stimulating Th2 cell proliferation and the release of Th2 cytokines. (see the "Initial" phase in the Figure below).

From this point forward, the outside-in theory is very similar to the inside-out theory.

Diagram of the Outside-Inside View of Atopic Dermatitis

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