Atopic Dermatitis beyond Eczema: A Review on its Systemic Impact through Pruritus and Associated Comorbidities

Abstract

Atopic dermatitis is the most prevalent chronic inflammatory skin disease, traditionally recognized for its defining eczematous lesions. However, the implications of atopic dermatitis extend far beyond eczema itself. Increasing understanding of the disease has enabled a more accurate characterization of its burden, including structural and functional skin alterations as well as various systemic comorbidities. This review examines the impact of the disease, beginning with the neuroimmune pathways underlying pruritus and its psychosocial burden, and progressing to the current concepts surrounding the atopic march and the broader spectrum of inflammatory or immune-mediated non-atopic comorbidities, including the emerging discussion on its similarities and differences with psoriasis. Special attention has been given to literature published from 2015 onwards. Ultimately, this review aims to deepen the understanding of the systemic nature of atopic dermatitis, providing a broader conceptual framework for assessing disease extent and severity.

Keywords: Atopic dermatitis; Atopic march; Comorbidities; Pruritus; Systemic inflammation.