The Atopic March and Atopic Multimorbidity: Many Trajectories, Many Pathways

The "atopic march" recognizes the increased occurrence of asthma and/or allergic rhinitis after atopic dermatitis (AD) onset. Mechanisms for developing atopic comorbidities after AD onset are poorly understood, but may involve the impaired cutaneous barrier, which facilitates cutaneous sensitization. The association may also be driven or amplified in susceptible individuals by a systemic Th2-dominant immune response to cutaneous inflammation. However, these associations may merely involve shared genetic loci and environmental triggers, including microbiome dysregulation, with the temporal sequence reflecting tissue-specific peak time of occurrence of each disease, suggesting more of a clustering of disorders than a march.

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