Is Atopic Dermatitis an Autoimmune Disease?

If you have ever filled out a medical history or family history at a rheumatologist’s office, you know they always ask for information on autoimmune diseases. Do you or your family have a history of arthritis, lupus, or MS? How about thyroid problems? Celiac disease? The list of potential conditions is generally long, but I’ve yet to encounter a questionnaire that includes atopic dermatitis.

Based on current research, that may be a problem.

Diagnosing autoimmune diseases

Autoimmune diseases are, in general, hard to diagnose. There are at least 80 different types of autoimmune diseases, and many of them imitate each other and/or share similar symptoms.¹ Many also share overlapping symptoms with diseases that are not (at this time) considered to be autoimmune in nature.

An accurate diagnosis is crucial for effective treatment, yet that diagnosis often takes an average of four years to achieve.² In many cases, personal and family medical history plays a role in arriving at answers. The fact that you or a close family member has atopic dermatitis may be important to your own or a loved one’s symptoms, and yet it’s rarely considered.

The immune system and inflammation

Immune system disorders are disorders in which the body’s immune system is either too active or too inactive. In the case of autoimmune disorders, the body’s immune system is too active, causing it to attack and damage itself. Inflammation is a classic sign of an autoimmune disease. Inflammation represents the body’s attempt to heal itself and repair damaged tissue.

Underlying chronic inflammation is a major component of atopic dermatitis. The skin inflammation associated with the condition is driven by effector cells and is considered a “type 2” immune response. Periostin, a protein that serves as a marker for a number of allergic diseases, including asthma, contributes to the clinical features of atopic dermatitis. It also contributes to the clinical features of other inflammatory skin diseases such as the autoimmune disease scleroderma.

Immune-specific treatment for eczema

In 2014, a study demonstrated that participants with eczema who were treated with a drug that targeted specific immune signaling proteins experienced significant symptom improvements compared to those participants treated with a placebo.³ That study opened the door for immune-specific treatments for atopic dermatitis and indicated that the condition is autoimmune in nature. Researchers discovered that an overactive immune system skewed toward allergy actually alters lipid formation in the skin of eczema patients, which affects the skin’s barrier.⁴ Studies show it is that change in the skin’s barrier that then leads to the dry, cracked, itchy skin that plagues those who live with atopic dermatitis.

Are autoimmune diseases linked?

An accurate medical history often grants doctors insights into a specific case or problem. Many conditions and diseases, including autoimmune diseases, have a genetic component. Atopic dermatitis appears to be one of these conditions. And considering that 25 percent of people who suffer from one autoimmune disorder end up having another, it’s also a condition worth mentioning to all of your doctors — not just your (or your child’s) dermatologist or PCP.⁵ An entirely different diagnosis might come easier to you or someone you love because you did.