Atopic Dermatitis in Otorhinolaryngology: Clinical Manifestations and Implications for Practice

Atopic dermatitis is a chronic inflammatory skin disease increasingly recognized as part of a broader atopic and type 2 inflammatory spectrum rather than a condition confined to the skin alone. Although its dermatologic burden is well established, its relevance to otorhinolaryngology remains relatively underrecognized. This narrative review examines atopic dermatitis from an otorhinolaryngology-centered perspective, focusing on ear, nose and throat (ENT) associations, clinical overlaps, shared inflammatory pathways, and practical implications for clinical care. Particular emphasis is placed on allergic rhinitis, chronic rhinosinusitis, ear-related eczematous manifestations, and the head and neck phenotype of atopic dermatitis. Shared pathophysiologic mechanisms, including epithelial barrier dysfunction, allergen sensitization, immune dysregulation, type 2 inflammation, microbiome alterations, and allergic multimorbidity, provide a framework for understanding these overlaps. Upper airway and ear-related conditions should not be interpreted as direct manifestations of atopic dermatitis in all patients, but as disorders that may coexist within a shared atopic or type 2 inflammatory background. The review further considers the implications of this perspective for targeted history-taking, differential diagnosis, referral decisions, therapeutic awareness, and multidisciplinary care. Overall, atopic dermatitis may serve as a clinically useful marker of broader allergic and inflammatory multimorbidity, with relevant implications for selected patients encountered in otorhinolaryngology practice.