What is interface dermatitis?

From the Guidelines

Interface dermatitis is a type of skin inflammation characterized by a vacuolar interface dermatitis with vacuolar changes of the epidermal basal layer, apoptosis, necrotic keratinocytes, and perivascular lymphocytic infiltrate and mucin deposition in the dermis, as described in the study by 1. This condition involves inflammation at the dermal-epidermal junction, which can be seen in various diseases, including dermatomyositis (DM) and lupus erythematosus. Key features of interface dermatitis include:

• Vacuolar changes of the epidermal basal layer
• Apoptosis
• Necrotic keratinocytes
• Perivascular lymphocytic infiltrate
• Mucin deposition in the dermis It is essential to differentiate interface dermatitis from other skin conditions, such as allergic contact dermatitis, which can have similar clinical presentations, as discussed in the study by 1. A skin biopsy can help confirm the diagnosis of interface dermatitis, and direct immunofluorescence can distinguish it from other conditions like lupus erythematosus, as mentioned in the study by 1. In terms of treatment, while there is no direct evidence provided in the given studies, the general approach to managing interface dermatitis involves reducing inflammation and preventing further irritation. The most effective treatment approach is not explicitly stated in the provided evidence, but based on the understanding of the condition, topical corticosteroids and oral antihistamines may be considered as potential treatment options, as they are commonly used to manage similar skin conditions, such as atopic dermatitis, as discussed in the studies by 1, 1, 1, and 1. However, it is crucial to consult the most recent and highest-quality study, such as the 2023 guideline by 1, which provides an updated approach to managing atopic dermatitis, a condition that may share similar treatment strategies with interface dermatitis.

From the Research

Definition and Characteristics of Interface Dermatitis

• Interface dermatitis is a histological inflammatory pattern characterized by a cytotoxic lymphocytic infiltration and a hydropic degeneration of the basal epidermal layer 2
• It is typically seen in autoimmune skin disorders such as lichen planus, cutaneous lupus erythematosus, and may also appear during immune reactions against drugs, viruses, and tumors 2
• Interface dermatitis can be linked to various conditions, including dermatomyositis, systemic lupus erythematosus, and Sjögren's syndrome 3

Pathogenesis and Immune Response

• The type-I IFN system is involved in cutaneous autoimmune diseases characterized by interface dermatitis, inducing the expression of proinflammatory cytokines and chemokines 2
• Interface dermatitis morphologically reflects a common IFN-driven cytotoxic attack affecting the basal keratinocytes under different conditions, which is important for antiviral and antitumor immune response, but is inappropriately activated in autoimmune skin disorders 2

Relationship to Other Skin Conditions

• Interface dermatitis is distinct from atopic dermatitis, which is a chronic, systemic, inflammatory disease characterized by persistent itch and marked redness 4, 5
• Atopic dermatitis is caused by a complex interaction of immune dysregulation, epidermal gene mutations, and environmental factors, and its treatment options are different from those for interface dermatitis 5