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JDD Special Focus

Atopic Dermatitis Articles

Stay up-to-date on new clinical findings in Atopic Dermatitis.  View the latest articles, case reports, supplements, CME activities, Podcast episodes and more!

 

Articles

Atopic Dermatitis: A Review of Current Diagnostic Criteria and a Proposed Update to Management 

Matthew Reynolds PA-C, Joe Gorelick RN MSN FNP-C, Matthew Bruno PA-C J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4737 

The objective of this review is to describe the current thinking on the clinical features of AD alongside current treatment guidelines, in order to consolidate and distill past and current criteria used in AD diagnosis, and thereby propose a more simplified set of diagnostic criteria.  

 

Topical Agents for the Treatment of Atopic Dermatitis 

Lawrence F. Eichenfield MD, Thomas Luger MD, Kim Papp MD, et al. J Drugs Dermatol. 2020;19(1):50-64. doi:10.36849/JDD.2020.4508 

This review summarizes the efficacy and safety data of topical therapies including corticosteroids, calcineurin inhibitors, and crisaborole and it shows that comparison among available agents is difficult because of differing methodologies used across clinical trials and that there is considerable variability in safety reporting among AD trials. 

 

A Global Review on the Risk Factors and Management of Early Atopic Dermatitis in Children Ages 0 to 2 Years Old 

Lawrence A. Schachner MD FAAD FAAP, Adelaide A. Hebert MD FAAD, Anneke Andriessen PhD, Latanya T. Benjamin MD FAAD FAAP, et al. J Drugs Dermatol. 2019;18(10):1020-1027. 

The current review aims to explore early intervention in infants and young children with eczema and AD-prone skin by improving skin barrier function and controlling inflammation at the earliest time point using a moisturizer and a proactive treatment. 

  

Dupilumab in Dermatology: Potential for Uses Beyond Atopic Dermatitis 

Nolan J. Maloney BS,Kyle Tegtmeyer BS, Jeffrey Zhao BA, Scott Worswick MD  J Drugs Dermatol. 2019;18(10):1053-1055. 

Given that dupilumab is relatively well tolerated and has shown efficacy in diseases mediated by Th2 processes, a new topic of interest is whether dupilumab might prove effective in other conditions in dermatology. 

 

Prescribing Patterns for Atopic Dermatitis in the United States 

Adrian Pona MD, Abigail Cline MD PhD, Sree S. Kolli BA, Steven R. Feldman MD PhD, Alan B. Fleischer Jr. MD  J Drugs Dermatol. 2019;18(10):987-990. 

Although pediatricians manage more AD visits than dermatologists in total visits, dermatologists manage more AD visits than pediatricians per physician. Characterizing how AD patients are currently treated may build a reference for future clinical research investigating novel standard-of-care treatment in AD. 

 

Efficacy of Dupilumab in Different Racial Subgroups of Adults With Moderate-to-Severe Atopic Dermatitis in Three Randomized, Placebo-Controlled Phase 3 Trials 

Andrew F. Alexis MD MPH, Marta Rendon MD, Jonathan I. Silverberg MD,  David M. Pariser MD,  et al.  J Drugs Dermatol. 2019;18(8):804-813.  ClinicalTrials.gov identifiers: NCT02277743, NCT02277769, NCT02260986  

Significant clinical improvement and a favorable benefit-risk profile can be achieved with dupilumab treatment in patients of White, Asian, and Black/African American racial subgroups with moderate-to-severe AD inadequately controlled with topical medications. 

 

Systemic Therapies for Moderate-to-Severe Atopic Dermatitis: Expert Perspectives in Practice 

Mark Lebwohl MD,  Andrew F. Alexis MD MPH,  Lisa A. Beck MD, et al.  J Drugs Dermatol. 2019;18(2):122-129. 

Recently published expert perspectives outlined recommendations for the diagnosis and treatment of moderate-to-severe AD in adults, reflecting evidence-based, practical recommendations to support allergists and dermatologists in selecting appropriate treatment in the era of biologic therapies. In these case studies, we demonstrate how AD severity, treatment response, and treatment failure can be assessed, and the role of emerging systemic treatments in the management of moderate-to-severe AD. 

 

Consensus Recommendations on Adjunctive Topical Management of Atopic Dermatitis 

James Q. Del Rosso DO, Julie Harper MD, Leon Kircik MD, et al. J Drugs Dermatol. 2018;17(10):1070-1076. 

This article provides succinct summaries of pathophysiology and medical management, and discussion of epidermal barrier dysfunction and skin microbiome shifting associated with AD. Additional emphasis is placed on adjunctive topical skin barrier approaches that may prolong disease-free remissions.  

 

Economic Evaluation of Dupilumab for Moderate-to-Severe Atopic Dermatitis: A Cost-Utility Analysis 

Marita Zimmermann MPH PhD,  David Rind MD MSc, Rick Chapman PhD, MS, et al. J Drugs Dermatol. 2018;17(7):750-756. 

Moderate-to-severe atopic dermatitis can be difficult and costly to treat. We aimed to identify the cost-effectiveness of dupilumab compared to usual care in moderate-to-severe atopic dermatitis. 

 

Navigating Targeted Therapeutics in Dermatology: Biologics and Small Molecules 

Collin M. Costello MD, Melody Maarouf MHS, Vivian Y. Shi MD  J Drugs Dermatol. 2018;17(12):1330-1332. 

Dermatology is entering an exciting era with new, targeted immune-modulating medications for treating a variety of dermatologic conditions including psoriasis, atopic dermatitis (AD), and hidradenitis suppurativa. Our understanding of cytokine signaling cascades has grown, presenting new opportunities to target skewed immune responses. Two major classes are biologics and small molecules. Herein, we highlight the similarities and differences between these two categories of targeted medications.  

 

Trends in Atopic Dermatitis Management: Comparison of 1990-1997 to 2003-2012 

Alice He BS, Steven R. Feldman MD PhD, and Alan B. Fleischer Jr. MD J Drugs Dermatol. 2018;17(2):135-140. 

Atopic dermatitis (AD) is primarily treated with topical therapies, systemic immunosuppressants, or adjunctive therapies. As novel treatment approaches for AD emerge, we characterize AD treatment and examine trends in treatment over time. We update these results with more recent data to examine trends in AD management over time. 

 

Update on the Systemic Risks of Superpotent Topical Steroids 

Mio Nakamura MD, Michael Abrouk MD, Henry Zhu MD, et al.  J Drugs Dermatol. 2017;16(7):643-648. 

 This article reviews all published clinical incidence of adrenal adverse effects in the medical literature, specifically Cushing’s syndrome (CS) and pathologic adrenal suppression (PAAS), to try to ascertain a more realistic limit for the safe use of superpotent topical steroids as it pertains to its potential systemic effects.

 

Treatment of Atopic Dermatitis in the United States: Analysis of Data from the National Ambulatory Medical Care Survey 

Sean P. McGregor DO PharmD, Michael E. Farhangian MD, Karen E. Huang MS, and Steven R. Feldman MD PhD J Drugs Dermatol. 2017;16(3):250-255.  

The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. There remains a disparity between dermatologists and non-dermatology specialties with regard to evidence-based approaches to the treatment of AD. 

 

Development of a Clinical Pathway for Atopic Dermatitis Patients: A Case-Based Approach 

Lyn C. Guenther MD FRCPC, Anneke Andriessen PhD, Charles W. Lynde MD FRCPC, et al. J Drugs Dermatol. 2016;15(12):1485-1494. 

 The purpose of this paper was to develop a practical case-based approach for the treatment and maintenance of AD, enabling translation of guidelines into clinical care. A patient focused clinical pathway with 7 cases was developed. For each case scenario, treatment for mild, moderate, and severe disease was recommended. 

 

The Role of Medical Nutrition Therapy in Dermatology and Skin Aesthetics: A Review

Martina M. Cartwright PhD RD, Emmy M. Graber MD MBA, Linda Stein Gold MD J Drugs Dermatol. 2020;19(1):12-18. doi:10.36849/JDD.2020.4745
The field of nutritional sciences has advanced beyond research of the role of individual nutrients, supplements and diet in disease to the multi-disciplinary practice of adjuvant medical nutrition therapy (MNT). Nutrition research is often that of association rather than cause and effect, yet there are compellingly strong relationships between diet and disease severity and incidence of a number of dermatological conditions. 

 

Efficacy of Topical Botanical Treatment of Children With Mild to Moderate Atopic Dermatitis

Zoe Diana Draelos MD, Michael Traub ND FABNO, Michael H. Gold MD, et al. J Drugs Dermatol. 2019;18(10):1038-1045.
The study was conducted to determine the efficacy of a botanical combination in a topical treatment for children with mild to moderate atopic dermatitis.

 

A Review of Topical Corticosteroid Foams

Jessica Payne BS, Kyle A. Habet MD, Adrian Pona MD, Steven R. Feldman MD PhD J Drugs Dermatol. 2019;18(8):756-770.

A Pubmed search was conducted up to April 1, 2019 using the keywords: “clobetasol,” “betamethasone,” “dipropionate,” “valerate,” “corticosteroids,” “desonide,” “topical,” “foam,” “vehicles,” “treatment,” and “clinical trial.” Forty articles out of 314 results were selected and read related to relevance.

 

IL-4 and IL-13 Inhibition in Atopic Dermatitis

Matthew C. Matsunaga MD and Paul S. Yamauchi MD PhD J Drugs Dermatol. 2016;15(8):925-929.
The aim of this article is to review the role of IL-4 and IL-13 in the pathogenesis of AD and discuss some of the clinical trial data that target and inhibit IL-4 and IL-13 in positively altering the course and outcome of AD.

 

Mycophenolate Mofetil in Severe Atopic Dermatitis: A Review

Lisa Prussick BSc, Natalia Plotnikova MD, and Alice Gottlieb MD PhDa J Drugs Dermatol. 2016;15(6):715-718.
This report summarizes the evidence for use of MMF in the treatment of recalcitrant AD for both children and adults. Familiarity with these studies on the benefits and risks of MMF will enable the clinician and patient to select the most appropriate therapy.

 

Asthma and Atopic Dermatitis: A Review of Targeted Inhibition of Interleukin-4 and Interleukin-13 As Therapy for Atopic Disease

Catherine D. Buzney MA, Alice B. Gottlieb MD PhD, David Rosmarin MD J Drugs Dermatol. 2016;15(2):165-171.
Type 2 helper T cell (Th2)-mediated inflammation plays a critical role in the pathogenesis of allergic asthma and atopic dermatitis (AD). Recent research focusing on the suppression of the Th2 axis with targeted inhibitors in atopic disease is showing promising early results.

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Podcast Episodes

Choosing Wisely: Capitalizing on Atopic Dermatitis Clinical Trial Data for Meaningful Selection of Topical Agents

We are finally getting what we asked for: Pharma is ponying up for head to head studies to provide us with meaningful data to help make better clinical decisions. However, these valuable projects are often with systemic agents, such as biologics, leaving topical treatments in the dust. To address this, Dr. Lawrence Eichenfield, Professor of Dermatology and Pediatrics, UCSD, and colleagues sought to make the most out of the data we do have on the litany of topical options for atopic dermatitis and provide efficacy and safety guidance (A for effort!). Tune in to hear what this dream team concocted about creams. Hear how an expert approaches new atopic dermatitis patients. Don’t miss out – this is all very topical.

Trending Now: Shifts and Gaps in Atopic Dermatitis Management by Derm and Non-Derm Physicians

Back by popular demand, Dr. Steven Feldman, Professor of Dermatology, Pathology and Public Health joins host Dr. Adam Friedman from GW School of Medicine to review his recent database dive entitled “Trends in Atopic Dermatitis Management: Comparison of 1990-1997 to 2003-2012.” What new trends, both good and bad, have emerged? What can we expect and hope for the future of AD care? What tricks of the trade do these two employ when utilizing systemic immunosuppressants? Itching for answers? Make sure to tune in…

Go superpotent or go home: The utility and safety of Class 1 topical steroids

In this edition of the JDD Podcast, Ask the Investigator, host Dr. Adam Friedman digs deep with UCSF Assistant Professor of Dermatology Dr. Tina Bhutani to powerlift the most up to date safety data on Class 1 superpotent topical steroids from her study entitled “Update on the Systemic Risks of Superpotent Topical Steroids.” Is steroid phobia valid, or does proper use of steroids properly protect from the adverse event boogeyman. Hear from the expert how to effectively use topical steroids while limiting local and systemic side effects, and how to get your patients on board, especially those nay sayers. Do not miss this clinically relevant and im-POTENT podcast ( nailed it!).

We’re Not Alone: The role of the cutaneous microbiota in maintaining skin health

In this special edition of the JDD podcast, with consideration from La Roche-Posay, host Dr. Adam Friedman is joined by Acne guru Dr. Hilary Baldwin, Director of the Acne Research Center and Associate Professor of Dermatology at SUNY Downstate, to review the cutting edge of cutaneous microbiome research and translational applications. Yes you are covered in bacteria – accept it, own it, and love it. Learn how harmony between the >500 species on our skin keep our barrier and cutaneous immunity in check, and conversely, how dysbiosis can facilitate a broad range of cutaneous pathology. This special edition is not to be missed!

CME Library

Learning Objectives: Upon completion of this enduring activity, participants should be able to discuss the efficacy and safety of different topicals indicated for topic dermatitis, and the unique approaches to managing this complex yet extremely common conditions.

 

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Translational Lecture Series

Targeting cAMP Signaling for the Treatment of Inflammatory Diseases of the Skin

Dr. Jon Zippin, Assistant Attending Dermatologist and Assistant Professor of Dermatology at Weill Medical College of Cornell, elucidates the complexity of cAMP biology and the translational impact of PDE4 inhibition as it relates to chronic inflammatory skin diseases. Tune in to learn why targeting this pathway is clinically meaningful but also where more work is needed to improve outcomes.

Update on Pediatric Inflammatory Skin Disorders: How Pathogenesis Informs Treatment

Dr. Amy Paller, Walter J. Hamlin Professor and Chair of Dermatology & Professor of Pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, delivers a presentation discussing the cause and treatment of pediatric Atopic Dematitis, including co-morbidities, epidermal barrier impairment, and compliance issues.

Itch form Bedside to Bench

Dr. Gil Yosipovitch, Professor of Dermatology at University of Miami Miller School of Medicine, provides residents and physicians access to the latest bench research and practical pearls from a master in pruritus that will help them offer the highest quality evidence-based dermatological care.

 

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