Karan Lal, DO: Atopic Dermatitis and the Aryl Hydrocarbon Receptor

In his latest HCPLive interview, Karan Lal, DO, MS, discussed his recent experience attending and presenting at the 2023 South Beach Symposium dermatology conference.

Lal is known for his work as the director of pediatric dermatology and cosmetic surgery at Affiliated Dermatology Scottsdale, in addition to being social media chair for the Society for Pediatric Dermatology.

He began by highlighting a topic he presented on during the conference, the contents of which covered disparities in dermatology care access.

“I had a really interesting topic, and that was, you know, pediatric dermatology and issues in the inner city,” Lal said. “And often when we talk about the inner city, we talk about things like poor access to medications, medication, non-compliance, you know. External factors that we don't have control over like environmental factors, such as poor housing conditions, pollution, etc.”

Lal went on to describe the presentation in further depth, highlighting some of the points he made on the aryl hydrocarbon receptor.

“It's a highly conserved pathway, which means it's been around for a very long time in our human genome,” he explained. “And we really didn't know what it did. But we know that the pathway is responsible for the proliferation of a lot of proteins that are very important for the skin barrier, like lauric, current involucre and filaggrin, and we know that these proteins are deficient in people who have atopic dermatitis.”

Lal went into more depth about the aryl hydrocarbon receptor pathway and the relationship with atopic dermatitis (AD).

“And we know the pathway is also associated with, and response to smoking and external factors like poly aromatic hydrocarbons,” he said. “And there's a lot of interesting data about how pollutants and pollution play a role in the propagation of atopic dermatitis.”

Lal explained that during the recent fires in California, a lot of patients were reporting flares in AD which prompted further investigation.

“And so people kind of delved into this, and figured out that it's probably related to this pathway, because a lot of pollutants, specifically poly aromatic hydrocarbons are lipid soluble,” he noted. “So they're able to enter into this cell, they bind to this receptor. This receptor leads to this weird propagation of events where not only does it allow for increased production of those proteins, but it actually changes the inflammatory milieu, and we know that the JAK STAT IL-4/IL-13 pathway, which is involved in atopic dermatitis, also, to some effect is mediated through this aryl hydrocarbon receptor pathway and has effects on this pathway.”

For further information on Lal’s recent insights, view the full HCPLive interview above.