Does exposure to tobacco smoke increase the risk of atopic dermatitis? A literature review

<ns3:p>Background: Allergies represent aberrant immune reactions to otherwise harmless substances, leading to various clinical symptoms, with atopic dermatitis (AD) being one of the most prevalent forms. AD is a chronic, recurrent inflammatory skin condition characterized by the typical distribution and distinctive morphology of lesions, as well as intense pruritus. Its development is influenced by genetic predispositions, environmental factors, and immune dysregulation, particularly the overproduction of immunoglobulin E (IgE) and a disrupted Th1/Th2 balance skewed toward the Th2 immune response.Aim of the study: This paper explores the multifactorial nature of AD, emphasizing the role of environmental tobacco smoke as a modifiable risk factor.Material and methods: PubMed and Medline databases were searched, and relevant literature was selected.Discussion: We did not find a significant correlation between either active smoking (OR 0.97, 95% CI [0.80; 1.18]) or passive smoking (OR 1.04, 95% CI [0.96; 1.13]) and the incidence of AD, due to the high heterogeneity of studies—some showing a negative effect and others a positive one. The mechanisms linking environmental tobacco smoke exposure to AD include alterations in epidermal barrier function, modulation of the immune response, and epigenetic changes affecting gene expression. Although a consensus is emerging that smoking exposure is associated with an increased risk of AD, many studies suggest a potential protective effect of smoking on AD pathogenesis.Conclusions: Continued research is necessary to address methodological limitations in existing studies and to elucidate the complex interplay between smoking and the pathogenesis of AD. Such understanding could inform public health initiatives aimed at reducing smoking exposure, particularly in vulnerable populations such as children and pregnant women.</ns3:p>