Navigating Atopic Dermatitis: Pathophysiology, Targeted Therapeutics, and Patient Perspectives
Atopic dermatitis is one of the most commonly treated conditions in dermatology. While previous treatments revolved around optimizing sensitive skincare regimens and topical corticosteroids. Dupilumab was a shift in treatment. From the point of its introduction onward, there has been a push toward greater understanding of the pathophysiology of atopic dermatitis. This has led to improvements in topicals, skincare regimens, and systemic treatments.
Regarding systemic options, treatments tend to include involvement of biologics targeting IL-4 and IL-13, or just IL-13. Guttman-Yassky et al showed improvements in lichenification in patients with atopic dermatitis. They furthermore stratified their results based on age and racial groups. Analyzing a distinct mechanism of action, Wagner et al investigated the use of nemolizumab as well as optimal clinical dosing in atopic dermatitis as opposed to its usual clinical indication of prurigo nodularis. This IL-31 monoclonal antibody had signs of improving atopic dermatitis.
While systemic treatments are becoming more targeted, topical treatments are often the mainstay of limited disease. Oscherwitz et al describe the topical treatment guidelines set forth by the American Academy of Dermatology. Additionally, an emerging topic in the treatment of atopic dermatitis is the role of the microbiome. Whiting et al describe the role of a moisturizer designed with the intention of optimizing the skin microbiome.
Finally, patient preference remains one of the key factors in guiding treatment decisions. To this end, Pedroza et al provide a literature review analyzing patient preferences for treatment. As treatments progress and become more optimized, it’s key that treatments are tailored to the specific patient and his/her goals.
REFERENCES
Dupilumab Treatment Improves Lichenification in Atopic Dermatitis in Different Age and Racial Groups
Topical Treatment of Atopic Dermatitis: An Adherence-Based Appraisal of the AAD Guidelines
Topical Treatment of Atopic Dermatitis: An Adherence-Based Appraisal of the AAD Guidelines
Effects on the Skin Microbiome by a Moisturizer Formulated for Eczema-Prone and Sensitive Skin
