Atopic dermatitis (AD) is a chronic inflammatory skin disease that often precedes asthma and allergic disorders. Recent insights into its genetics and pathophysiology highlight the importance of structural abnormalities in the epidermis and immune dysregulation. Patients with AD have a unique predisposition to microbial colonization and infection, particularly by *Staphylococcus aureus* and herpes simplex virus. Treatment strategies should focus on healing and protecting the skin barrier and addressing immune dysregulation. Genetic studies have identified several genes associated with AD, including *FLG*, which encodes filaggrin, a key component of the epidermal barrier. Mutations in *FLG* are strongly linked to AD and are associated with increased risk of asthma and allergic disorders. Environmental factors, such as prenatal exposure to farm animals and cats, can influence the development of AD. Proteomic studies have revealed changes in epidermal protein profiles in AD patients, suggesting that barrier defects and immune dysregulation are interrelated. Mouse models and clinical studies have provided further insights into the role of tight junctions and immune cells in AD. New therapeutic strategies, including targeted immunomodulatory treatments and vaccines against *S. aureus*, are being explored to improve outcomes for AD patients.Atopic dermatitis (AD) is a chronic inflammatory skin disease that often precedes asthma and allergic disorders. Recent insights into its genetics and pathophysiology highlight the importance of structural abnormalities in the epidermis and immune dysregulation. Patients with AD have a unique predisposition to microbial colonization and infection, particularly by *Staphylococcus aureus* and herpes simplex virus. Treatment strategies should focus on healing and protecting the skin barrier and addressing immune dysregulation. Genetic studies have identified several genes associated with AD, including *FLG*, which encodes filaggrin, a key component of the epidermal barrier. Mutations in *FLG* are strongly linked to AD and are associated with increased risk of asthma and allergic disorders. Environmental factors, such as prenatal exposure to farm animals and cats, can influence the development of AD. Proteomic studies have revealed changes in epidermal protein profiles in AD patients, suggesting that barrier defects and immune dysregulation are interrelated. Mouse models and clinical studies have provided further insights into the role of tight junctions and immune cells in AD. New therapeutic strategies, including targeted immunomodulatory treatments and vaccines against *S. aureus*, are being explored to improve outcomes for AD patients.