Effector pathways during eczematous dermatitis: where inflammation meets cell death

During eczematous skin inflammation, the main constituents of the skin, keratinocytes (KC), play an important role in inducing and shaping the immunological response to environmental stimuli. This review focuses on the epidermal inflammation caused by keratinocyte-T cell interactions arising from a disturbed barrier function of the skin. In eczematous dermatitis, activated dermis- and epidermis-infiltrating T cells target KC for apoptosis. In turn, damaged KC respond by secreting inflammatory mediators, thus effecting further recruitment of immunocytes to inflamed skin. Further advances will come from identification of the immunoregulatory mechanisms involved in the pathogenesis of eczematous dermatitis. Potential therapeutic interventions are discussed.