JDD Special Focus

Atopic Dermatitis Articles

Analysis of Reddit Reveals Atopic Dermatitis Patient Questions

Alana Kurtti BS, Jared Jagdeo MD MS J Drugs Dermatol. 2021;20(6): doi:10.36849/JDD.5734

Reddit, the seventh most visited website in the United States, has become an exceedingly popular platform for patients to source medical information and discuss chronic conditions. We analyzed 1,000 questions from 881 posts. The highest proportion of questions (29.5%) were non-pharmacologic management focused, with patients inquiring about diet, over the counter skincare products, personal hygiene practices, clothing, and supplements. Non-specific management (19.1%), uncertainty about symptoms (14.6%), medications (14.3%), cause and triggers (10.3%), and mental health (6.9%) were common categories as well.

Clinical Relevance of Skin Pain in Atopic Dermatitis

Sonja Ständer MD, Eric L. Simpson MD, Emma Guttman-Yassky MD, Jacob P. Thyssen MD, Kenji Kabashima MD, Susan G. Ball PhD, Maria Jose Rueda MD, Amy M. DeLozier MPH, Jonathan I. Silverberg MD J Drugs Dermatol. 2020;19(10)921-926. doi:10.36849/JDD.2020.5498

This review discusses the clinical relevance of skin pain with respect to its experience, pathophysiology, relationship with itch, and treatment implications. Recent studies suggest that skin pain presents as a neuropathic symptom independent from itch and the “itch-scratch cycle”, and poses a unique burden to patients.

Development and Evaluation of an Atopic Dermatitis Care Plan for Providers

Collette Utley DNP FNP-BC PNP-BC, Michael H. Gold MD FAAD, Melissa Hall DNP FNP-BC AGPNP-BC J Drugs Dermatol. 2020;19(10): 950-955. doi:10.36849/JDD.2020.5090

A universal AD care plan was developed to improve AD disease management and patient outcomes. Post-implementation of providers’ perceptions was assessed for how the AD universal care plan affected their ability to provide patient education.

Topical Agents Currently in Phase II or Phase III Trials for Atopic Dermatitis

Shelley K. Uppal BS, Vipawee S. Chat BA, Donovan G. Kearns BS, Jashin J. Wu MD J Drugs Dermatol. 2020;19(10):956-959. doi:10.36849/JDD.2020.5214

A systemic literature review was performed to examine the safety and efficacy of topical agents currently in phase II and phase III clinical trials for AD. Our team searched the databases, PubMed, Google Scholar, and ClinicalTrials.gov, on March 2020 for studies pertaining to the use of topical agents in AD. Key words included each drug or “topical agents” combined with “atopic dermatitis.”

The ABC Topical Management of Atopic Dermatitis in Philippines: Expert Recommendations

Angela M Lavadia MD, Angela T Cumagun MD, Lourdes Palmero MD, Noemie Salta Ramos MD, Cindy Jao Tan MD J Drugs Dermatol. 2021;20(1):84-87. doi:10.36849/JDD.2021.5080

An ABC scheme of atopic dermatitis (AD) management entails anti-inflammatory, barrier repair and basic skin care strategies to adequately manage AD. It is an easy-to-follow model which helps lessen distress and improve the quality of life amongst patients. An expert panel composed of specialists in the field of dermatology and pediatric dermatology in the Philippines convened to review current data and management practices in order to provide key treatment recommendations and identify current gaps in the treatment of mild to moderate atopic dermatitis. This scientific expert panel, likewise, seeks to provide guidance for all healthcare professionals involved in the care and management of AD patients.

Atopic Dermatitis and the Role of the Skin Microbiome in Choosing Prevention, Treatment, and Maintenance Options

Hilary Baldwin MD, Crystal Aguh MD, Anneke Andriessen PhD, Latanya Benjamin MD FAAP FAAD, Aaron S. Ferberg MD, Deirdre Hooper MD FAAD, Joseph L. Jarizzo MD, Peter A. Lio MD, Brook Tlougan MD FAADI, Heather C. Woolery-Lloyd MD, Joshua Zeichner MD FAAD  J Drugs Dermatol. 2020;19(10):935-940. doi:10.36849/JDD.2020.5393

Atopic dermatitis (AD) is a common skin condition characterized by disturbed barrier function, skin inflammation, and cutaneous dysbiosis. Clinically, it manifests as chronic-recurrent xerosis, pruritus, and erythematous lesions. Its pathophysiology is complex, making the selection of appropriate treatment options a task.  Results from an expert panel were summarized and discussed to provide updated recommendations for the treatment and maintenance of atopic dermatitis. Normalization of skin microbiome diversity using a topical moisturizer containing post-biotic aqua and biomass may offer a valuable option for the treatment and maintenance of inflammatory skin diseases. 

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 conflicting 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. 

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. 

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.  

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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!

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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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